ICD-10 Coding for Diabetes Mellitus with Peripheral Neuropathy(E11.42, E10.42)
Complete ICD-10-CM coding and documentation guide for Diabetes Mellitus with Peripheral Neuropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetes Mellitus with Peripheral Neuropathy
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy | Use when documenting Type 2 diabetes with confirmed diabetic polyneuropathy. |
|
| E10.42 | Type 1 diabetes mellitus with diabetic polyneuropathy | Use when documenting Type 1 diabetes with confirmed diabetic polyneuropathy. |
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Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for diabetes mellitus with peripheral neuropathy
Essential facts and insights about Diabetes Mellitus with Peripheral Neuropathy
Primary ICD-10-CM Codes for diabetes mellitus with peripheral neuropathy
Decision Criteria
clinical Criteria
- Presence of bilateral neuropathic symptoms linked to diabetes
coding Criteria
- Avoid using G62.9 when neuropathy is diabetic
Applicable To
- Diabetic sensorimotor polyneuropathy
Excludes
- Polyneuropathy due to other causes (G62.9)
Clinical Validation Requirements
- Bilateral symptoms such as numbness or tingling
- Linkage to diabetes, e.g., 'due to diabetes'
- Exclusion of mononeuropathy
Code-Specific Risks
- Incorrectly coding as G62.9 when neuropathy is diabetic
Coding Notes
- Ensure documentation explicitly links neuropathy to diabetes.
E10.42 - Type 1 diabetes mellitus with diabetic polyneuropathy
Use when documenting Type 1 diabetes with confirmed diabetic polyneuropathy.
Applicable To
- Diabetic sensorimotor polyneuropathy
Excludes
- Polyneuropathy due to other causes (G62.9)
Clinical Validation Requirements
- Bilateral symptoms such as numbness or tingling
- Linkage to diabetes, e.g., 'due to diabetes'
- Exclusion of mononeuropathy
Coding Notes
Ensure documentation explicitly links neuropathy to diabetes.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Unspecified polyneuropathy
G62.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetes Mellitus with Peripheral Neuropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.42.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always specify if neuropathy is diabetic., Include bilateral symptoms in documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on diabetes complications.
Mitigation Strategy
Use E11.42 or E10.42 for diabetic neuropathy.
Impact
Using G62.9 instead of E11.42 for diabetic neuropathy.
Mitigation Strategy
Educate coders on proper code selection and documentation requirements.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Diabetes Mellitus with Peripheral Neuropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetes Mellitus with Peripheral Neuropathy
Use these documentation templates to ensure complete and accurate documentation for Diabetes Mellitus with Peripheral Neuropathy. These templates include all required elements for proper coding and billing.
Neurology Progress Note
Specialty: NeurologyRequired Elements
- Subjective symptoms
- Objective findings
- Assessment
- Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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