ICD-10 Coding for History of Diabetes(Z86.39, Z83.3)
Complete ICD-10-CM coding and documentation guide for History of Diabetes. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Diabetes
Z80-Z99Primary Range
Factors influencing health status and contact with health services
This range includes codes for personal and family history of diseases, including resolved diabetes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z86.39 | Personal history of other endocrine, nutritional, and metabolic disease | Use when diabetes is resolved and no longer requires treatment. |
|
| Z83.3 | Family history of diabetes mellitus | Use for documenting familial risk factors, not for the patient's own history. |
|
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 history of diabetes
Essential facts and insights about History of Diabetes
Primary ICD-10-CM Codes for history of diabetes
Decision Criteria
clinical Criteria
- Diabetes is resolved with no ongoing treatment.
documentation Criteria
- Patient's medical record must state 'resolved' or 'history of' diabetes.
Applicable To
- Resolved diabetes
Excludes
- Active diabetes (E10-E13)
Clinical Validation Requirements
- Documented resolution of diabetes
- Normal HbA1c levels without medication
Code-Specific Risks
- Incorrectly coding active diabetes as resolved
Coding Notes
- Ensure documentation clearly states diabetes is resolved.
Z83.3 - Family history of diabetes mellitus
Use for documenting familial risk factors, not for the patient's own history.
Applicable To
- Family history of diabetes
Excludes
- Personal history of diabetes (Z86.39)
Clinical Validation Requirements
- Documented family history of diabetes
Coding Notes
Do not use for the patient's own resolved diabetes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Diabetes to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.39.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific language like 'resolved' or 'history of'.
Impact
Reimbursement: May lead to undercoding and affect risk adjustment scores., Compliance: Incorrect coding can lead to compliance issues., Data Quality: Impacts the accuracy of patient health records.
Mitigation Strategy
Use E11.9 for active diabetes, even if controlled.
Impact
Using history codes for active diabetes.
Mitigation Strategy
Regular training on coding guidelines.
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 History of Diabetes, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Diabetes
Use these documentation templates to ensure complete and accurate documentation for History of Diabetes. These templates include all required elements for proper coding and billing.
Resolved Diabetes Post-Transplant
Specialty: EndocrinologyRequired Elements
- Resolution date
- Current HbA1c levels
- Medication status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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