ICD-10 Coding for Diabetes with Polyneuropathy(E11.42, E10.42)
Complete ICD-10-CM coding and documentation guide for Diabetes with Polyneuropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetes with Polyneuropathy
E08-E13Primary Range
Diabetes mellitus
This range includes all types of diabetes mellitus and their complications, including diabetic polyneuropathy.
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 Type 2 diabetes is documented with symptoms of polyneuropathy. |
|
| E10.42 | Type 1 diabetes mellitus with diabetic polyneuropathy | Use when Type 1 diabetes is documented with symptoms of polyneuropathy. |
|
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 with polyneuropathy
Essential facts and insights about Diabetes with Polyneuropathy
Primary ICD-10-CM Codes for diabetes with polyneuropathy
Decision Criteria
clinical Criteria
- Presence of bilateral sensory loss and abnormal monofilament testing
Applicable To
- Type 2 diabetes with bilateral foot numbness
Excludes
- Diabetic mononeuropathy (E11.41)
Clinical Validation Requirements
- Bilateral numbness/tingling in extremities
- Decreased vibration sense
- Absent ankle reflexes
Code-Specific Risks
- Ensure bilateral symptoms are documented to avoid incorrect coding.
Coding Notes
- Always verify the type of diabetes and ensure documentation supports polyneuropathy.
E10.42 - Type 1 diabetes mellitus with diabetic polyneuropathy
Use when Type 1 diabetes is documented with symptoms of polyneuropathy.
Applicable To
- Type 1 diabetes with diabetic polyneuropathy
Excludes
- Diabetic mononeuropathy (E10.41)
Clinical Validation Requirements
- Bilateral sensory loss
- Confirmed Type 1 diabetes
Coding Notes
Ensure documentation specifies Type 1 diabetes with polyneuropathy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of insulin
Z79.4Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetes with Polyneuropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.42.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always specify 'polyneuropathy' if applicable.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Query provider to confirm if neuropathy is diabetic in origin.
Impact
Lack of specificity in documenting neuropathy type.
Mitigation Strategy
Ensure detailed documentation of symptoms and diabetes type.
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 with Polyneuropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetes with Polyneuropathy
Use these documentation templates to ensure complete and accurate documentation for Diabetes with Polyneuropathy. These templates include all required elements for proper coding and billing.
Diabetes with Polyneuropathy
Specialty: EndocrinologyRequired Elements
- Type of diabetes
- Bilateral sensory loss
- Objective testing results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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