ICD-10 Coding for Glycosylated Hemoglobin(E11.9, R73.09)
Complete ICD-10-CM coding and documentation guide for Glycosylated Hemoglobin. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Glycosylated Hemoglobin
E08-E13Primary Range
Diabetes mellitus codes
These codes cover various types of diabetes, which are diagnosed and monitored using glycosylated hemoglobin levels.
Abnormal glucose levels
This range includes codes for prediabetes and other abnormal glucose findings that may be identified through HbA1c testing.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.9 | Type 2 diabetes mellitus without complications | Use when diagnosing Type 2 diabetes without any documented complications. |
|
| R73.09 | Other abnormal glucose | Use for patients with elevated HbA1c levels indicating prediabetes. |
|
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 hemoglobin A1c
Essential facts and insights about Glycosylated Hemoglobin
Primary ICD-10-CM Codes for glycosylated hemoglobin
Decision Criteria
clinical Criteria
- HbA1c ≥6.5% with no complications
Applicable To
- Type 2 diabetes mellitus
Excludes
- Type 1 diabetes mellitus (E10.-)
Clinical Validation Requirements
- HbA1c ≥6.5% confirms diagnosis
Code-Specific Risks
- Ensure HbA1c level is documented to support diagnosis.
Coding Notes
- Document HbA1c levels and any symptoms or complications to ensure accurate coding.
R73.09 - Other abnormal glucose
Use for patients with elevated HbA1c levels indicating prediabetes.
Applicable To
- Prediabetes
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- HbA1c between 5.7% and 6.4%
Coding Notes
Monitor HbA1c levels regularly to track progression to diabetes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other abnormal glucose
R73.09Differential 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 Glycosylated Hemoglobin to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.9.
Impact
Clinical: Inaccurate diabetes management., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Regularly review lab results., Ensure documentation includes all relevant test results.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Always use the most specific code available based on documentation.
Impact
Lack of HbA1c documentation can trigger audits.
Mitigation Strategy
Ensure all HbA1c results are documented and linked to diagnoses.
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 Glycosylated Hemoglobin, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Glycosylated Hemoglobin
Use these documentation templates to ensure complete and accurate documentation for Glycosylated Hemoglobin. These templates include all required elements for proper coding and billing.
Diabetes follow-up visit
Specialty: EndocrinologyRequired Elements
- HbA1c value
- Diabetes type
- Complication status
- Treatment adherence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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