ICD-10 Coding for High Blood Sugar(E11.65, R73.9)
Complete ICD-10-CM coding and documentation guide for High Blood Sugar. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to High Blood Sugar
E11.6-E11.69Primary Range
Type 2 diabetes mellitus with complications
This range includes codes for Type 2 diabetes with various complications, including hyperglycemia.
Abnormal glucose levels
This range is used for abnormal glucose levels without a diabetes diagnosis.
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 a patient with Type 2 diabetes presents with elevated blood glucose levels. |
|
| R73.9 | Unspecified abnormal glucose | Use when elevated glucose is noted 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 high blood sugar
Essential facts and insights about High Blood Sugar
Primary ICD-10-CM Codes for high blood sugar
Decision Criteria
clinical Criteria
- Patient has Type 2 diabetes with documented hyperglycemia.
documentation Criteria
- Lab results showing elevated glucose levels are present.
Applicable To
- Type 2 diabetes with elevated blood glucose
- Type 2 diabetes with poorly controlled blood sugar
Excludes
- Type 1 diabetes mellitus with hyperglycemia (E10.65)
Clinical Validation Requirements
- Fasting glucose ≥126 mg/dL
- Random glucose ≥200 mg/dL
- A1C ≥6.5%
Code-Specific Risks
- Incorrectly coding without diabetes linkage
- Omitting necessary documentation of glucose levels
Coding Notes
- Ensure documentation specifies hyperglycemia and includes lab values.
R73.9 - Unspecified abnormal glucose
Use when elevated glucose is noted without a diabetes diagnosis.
Applicable To
- Elevated blood sugar without diabetes diagnosis
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- Glucose >125 mg/dL in non-diabetic patient
Coding Notes
Do not use if diabetes is diagnosed.
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 High Blood Sugar to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.65.
Impact
Clinical: May lead to inappropriate treatment adjustments., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or audits.
Mitigation Strategy
Use specific terms like 'hyperglycemia' with lab values, Educate providers on documentation standards
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Default to E11.65 unless diabetes is explicitly ruled out.
Impact
Using R73.9 when diabetes is present.
Mitigation Strategy
Educate coders on proper code selection and 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 High Blood Sugar, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for High Blood Sugar
Use these documentation templates to ensure complete and accurate documentation for High Blood Sugar. These templates include all required elements for proper coding and billing.
Type 2 Diabetes with Hyperglycemia
Specialty: EndocrinologyRequired Elements
- Patient's glucose levels
- A1C results
- Current diabetes management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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