ICD-10 Coding for High Glucose(E11.65, R73.01)
Complete ICD-10-CM coding and documentation guide for High Glucose. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to High 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 hyperglycemia is documented in a patient with Type 2 diabetes. |
|
| R73.01 | Impaired fasting glucose | Use for non-diabetic patients with impaired fasting glucose. |
|
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 glucose
Essential facts and insights about High Glucose
Primary ICD-10-CM Codes for high glucose
Decision Criteria
clinical Criteria
- Documented hyperglycemia in a Type 2 diabetic patient.
Applicable To
- Type 2 diabetes with high blood sugar
Excludes
- Type 1 diabetes mellitus with hyperglycemia (E10.65)
Clinical Validation Requirements
- Random glucose ≥200 mg/dL with symptoms
- A1C ≥6.5% with documented hyperglycemia
Code-Specific Risks
- Misuse when hyperglycemia is not specified in documentation.
Coding Notes
- Ensure hyperglycemia is explicitly documented to avoid audits.
R73.01 - Impaired fasting glucose
Use for non-diabetic patients with impaired fasting glucose.
Applicable To
- Prediabetes
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- Fasting glucose 100-125 mg/dL
Coding Notes
Ensure fasting glucose levels are documented.
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 High 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: Inaccurate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure detailed documentation of glucose levels., Regularly review coding guidelines.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate health records and data reporting.
Mitigation Strategy
Query provider for specification of hyperglycemia or hypoglycemia.
Impact
Increased audit risk when hyperglycemia is not documented.
Mitigation Strategy
Ensure all diabetes diagnoses specify glucose abnormalities.
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 Glucose, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for High Glucose
Use these documentation templates to ensure complete and accurate documentation for High Glucose. 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 medication regimen
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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