ICD-10 Coding for Hemoglobin Glycosylated(E11.9, R73.03)
Complete ICD-10-CM coding and documentation guide for Hemoglobin Glycosylated. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hemoglobin Glycosylated
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 a patient has type 2 diabetes without any documented complications. |
|
| R73.03 | Prediabetes | Use when HbA1c indicates prediabetes 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 hemoglobin glycosylated
Essential facts and insights about Hemoglobin Glycosylated
Primary ICD-10-CM Codes for hemoglobin glycosylated
Decision Criteria
clinical Criteria
- Patient has type 2 diabetes confirmed by HbA1c ≥6.5%
Applicable To
- Type 2 diabetes mellitus
Excludes
- Type 1 diabetes mellitus
Clinical Validation Requirements
- Diagnosis of type 2 diabetes
- HbA1c ≥6.5%
Code-Specific Risks
- Ensure diabetes type is correctly documented.
Coding Notes
- Ensure to document the type of diabetes clearly.
R73.03 - Prediabetes
Use when HbA1c indicates prediabetes without a diabetes diagnosis.
Applicable To
- Impaired fasting glucose
- Impaired glucose tolerance
Excludes
- Diabetes mellitus
Clinical Validation Requirements
- HbA1c 5.7-6.4%
- Fasting glucose 100-125 mg/dL
Coding Notes
Ensure HbA1c results are documented to support prediabetes diagnosis.
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 Hemoglobin Glycosylated 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 treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify diabetes type in documentation.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure HbA1c results are documented to support prediabetes diagnosis.
Impact
Inadequate documentation of HbA1c testing frequency and necessity.
Mitigation Strategy
Ensure all HbA1c tests are justified with clinical notes.
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 Hemoglobin Glycosylated, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hemoglobin Glycosylated
Use these documentation templates to ensure complete and accurate documentation for Hemoglobin Glycosylated. These templates include all required elements for proper coding and billing.
Diabetes Management
Specialty: EndocrinologyRequired Elements
- Patient's diabetes type
- HbA1c result
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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