ICD-10 Coding for Elevated Glucose(E11.65, R73.09)
Complete ICD-10-CM coding and documentation guide for Elevated Glucose. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Glucose
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.65 | Type 2 diabetes mellitus with hyperglycemia | Use when Type 2 diabetes and hyperglycemia are documented together. |
|
| R73.09 | Other abnormal glucose | Use when abnormal glucose is documented without a diabetes diagnosis. |
|
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 elevated glucose
Essential facts and insights about Elevated Glucose
Primary ICD-10-CM Codes for elevated glucose
Decision Criteria
clinical Criteria
- Documented Type 2 diabetes with hyperglycemia
documentation Criteria
- Provider notes linking diabetes and hyperglycemia
Applicable To
- Type 2 diabetes with high blood sugar
Excludes
- Type 1 diabetes with hyperglycemia (E10.65)
Clinical Validation Requirements
- Provider documentation of Type 2 diabetes and hyperglycemia
- Fasting glucose ≥126 mg/dL
Code-Specific Risks
- Assuming hyperglycemia based on lab results without provider documentation
Coding Notes
- Ensure hyperglycemia is documented by the provider.
R73.09 - Other abnormal glucose
Use when abnormal glucose is documented without a diabetes diagnosis.
Applicable To
- Prediabetes
- Impaired glucose regulation
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- Fasting glucose 100-125 mg/dL
- OGTT 140-199 mg/dL
Coding Notes
Ensure no diabetes diagnosis is present.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of insulin
Z79.4Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Elevated Glucose to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.65.
Impact
Clinical: Misrepresentation of patient's condition, Regulatory: Non-compliance with coding standards, Financial: Potential for denied claims
Mitigation Strategy
Verify provider documentation, Query for clarification if needed
Impact
Reimbursement: Incorrect DRG assignment, affecting payment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Query provider for confirmation of hyperglycemia.
Impact
Lack of explicit documentation linking diabetes and hyperglycemia.
Mitigation Strategy
Educate providers on 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 Elevated Glucose, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Glucose
Use these documentation templates to ensure complete and accurate documentation for Elevated Glucose. These templates include all required elements for proper coding and billing.
Type 2 Diabetes with Hyperglycemia
Specialty: EndocrinologyRequired Elements
- Diagnosis of Type 2 diabetes
- Documentation of hyperglycemia
- Treatment plan including insulin use
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Elevated Glucose? Ask your questions below.