ICD-10 Coding for Hyperglycemia(E11.65, R73.9)
Complete ICD-10-CM coding and documentation guide for Hyperglycemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hyperglycemia
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 as a complication of type 2 diabetes. |
|
| R73.9 | Hyperglycemia, unspecified | Use for transient hyperglycemia not linked to diabetes. |
|
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 hyperglycemia
Essential facts and insights about Hyperglycemia
Primary ICD-10-CM Codes for hyperglycemia
Decision Criteria
clinical Criteria
- Documented blood glucose >200 mg/dL with symptoms
Applicable To
- Type 2 diabetes with high blood sugar
Excludes
- Diabetic ketoacidosis (E11.10)
Clinical Validation Requirements
- Blood glucose >200 mg/dL
- A1C >7%
- Symptoms such as polyuria or polydipsia
Code-Specific Risks
- Incorrectly coding as E11.9 without specifying hyperglycemia
Coding Notes
- Ensure hyperglycemia is explicitly documented by the provider.
R73.9 - Hyperglycemia, unspecified
Use for transient hyperglycemia not linked to diabetes.
Applicable To
- Unspecified hyperglycemia
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- Transient elevated glucose without diabetes diagnosis
Coding Notes
Do not use for diabetic patients.
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 Hyperglycemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.65.
Impact
Clinical: Misrepresents patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Review documentation for hyperglycemia, Query provider if unclear
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure hyperglycemia is explicitly documented by the provider.
Impact
Misclassification of diabetes without complications when hyperglycemia is present.
Mitigation Strategy
Ensure thorough review of clinical documentation.
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 Hyperglycemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hyperglycemia
Use these documentation templates to ensure complete and accurate documentation for Hyperglycemia. These templates include all required elements for proper coding and billing.
Type 2 diabetes with hyperglycemia
Specialty: EndocrinologyRequired Elements
- Blood glucose levels
- Symptoms
- Management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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