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ICD-10 Coding for Diabetic Ketoacidosis Type 1(E10.10, E10.11)

Complete ICD-10-CM coding and documentation guide for Diabetic Ketoacidosis Type 1. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

DKA Type 1Type 1 Diabetes with Ketoacidosis

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Related ICD-10 Code Ranges

Complete code families applicable to Diabetic Ketoacidosis Type 1

E10.1-E10.19Primary Range

Type 1 Diabetes Mellitus with Ketoacidosis

This range includes codes specific to Type 1 Diabetes with ketoacidosis, both with and without coma.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
E10.10Type 1 diabetes mellitus with ketoacidosis without comaUse when Type 1 diabetes is present with ketoacidosis but without coma.
  • pH <7.3
  • Serum bicarbonate <18 mmol/L
  • Ketonuria
E10.11Type 1 diabetes mellitus with ketoacidosis with comaUse when Type 1 diabetes is present with ketoacidosis and coma.
  • Comatose state
  • Glasgow Coma Scale ≤8
  • Mechanical ventilation documentation

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 diabetic ketoacidosis type 1

Essential facts and insights about Diabetic Ketoacidosis Type 1

The ICD-10 code for diabetic ketoacidosis type 1 without coma is E10.10, and with coma is E10.11.

Primary ICD-10-CM Codes for diabetic ketoacidosis type 1

E10.10
Type 1 diabetes mellitus with ketoacidosis without coma
Billable Code

Decision Criteria

clinical Criteria

  • Presence of ketoacidosis without coma in Type 1 diabetes.

Applicable To

  • Type 1 diabetes with ketoacidosis

Excludes

  • Type 2 diabetes mellitus with ketoacidosis (E11.10)

Clinical Validation Requirements

  • pH <7.3
  • Serum bicarbonate <18 mmol/L
  • Ketonuria

Code-Specific Risks

  • Ensure documentation supports the absence of coma.

Coding Notes

  • Ensure all lab values supporting DKA are documented.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Acidosis

E87.2
Use if acidosis is present but DKA criteria are not fully met.

Unspecified coma

R40.20
Use to specify coma status if not detailed elsewhere.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Type 2 diabetes mellitus without complications

E11.00
Type 2 diabetes without ketoacidosis.

Type 2 diabetes mellitus with ketoacidosis with coma

E11.11
Type 2 diabetes with ketoacidosis and coma.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Diabetic Ketoacidosis Type 1 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E10.10.

Impact

Clinical: Inaccurate clinical picture of patient's condition., Regulatory: Potential audit issues due to incomplete documentation., Financial: Possible reimbursement issues due to incorrect coding.

Mitigation Strategy

Always document coma status when coding E10.11.

Impact

Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Always use E10.1x when DKA criteria are met.

Impact

Missing lab values or coma status can trigger audits.

Mitigation Strategy

Ensure comprehensive documentation of all clinical criteria for DKA.

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 Diabetic Ketoacidosis Type 1, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Diabetic Ketoacidosis Type 1

Use these documentation templates to ensure complete and accurate documentation for Diabetic Ketoacidosis Type 1. These templates include all required elements for proper coding and billing.

Emergency Department Note for DKA

Specialty: Emergency Medicine

Required Elements

  • Assessment of DKA
  • Lab values: pH, bicarbonate, glucose
  • Treatment plan: insulin, fluids

Example Documentation

**Assessment**: Type 1 diabetes mellitus with ketoacidosis (E10.10). pH: 7.22, Bicarb: 14 mmol/L, Glucose: 420 mg/dL. **Plan**: Start insulin drip at 0.1 units/kg/hr, fluid resuscitation.

Examples: Poor vs. Good Documentation

Poor Documentation Example
DKA managed with insulin
Good Documentation Example
Type 1 DM with ketoacidosis (pH 7.25, bicarb 16, glucose 380 mg/dL). Insulin drip initiated at 0.1 units/kg/hr. Urine ketones large (160 mg/dL). No coma present.
Explanation
The good example provides specific lab values and treatment details, supporting the DKA diagnosis.

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