ICD-10 Coding for Hyperglycemic Crisis(E11.01, E11.10)
Complete ICD-10-CM coding and documentation guide for Hyperglycemic Crisis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hyperglycemic Crisis
E11.0-E11.9Primary Range
Type 2 Diabetes Mellitus
Covers complications of Type 2 Diabetes including hyperglycemic crises such as DKA and HHS.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.01 | Type 2 diabetes mellitus with hyperosmolarity with coma | Use when hyperosmolar hyperglycemic state is present with coma. |
|
| E11.10 | Type 2 diabetes mellitus with ketoacidosis without coma | Use when DKA is present without coma. |
|
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 hyperglycemic crisis
Essential facts and insights about Hyperglycemic Crisis
Primary ICD-10-CM Codes for hyperglycemic crisis
Decision Criteria
clinical Criteria
- Presence of coma in hyperosmolar state
Applicable To
- Hyperosmolar hyperglycemic state with coma
Excludes
- Diabetic ketoacidosis (E11.10)
Clinical Validation Requirements
- Glucose >600 mg/dL
- Serum osmolality >320 mOsm/kg
- Altered mental status or coma
Code-Specific Risks
- Ensure documentation of coma status to justify use.
Coding Notes
- Ensure clear documentation of mental status and lab values.
E11.10 - Type 2 diabetes mellitus with ketoacidosis without coma
Use when DKA is present without coma.
Applicable To
- Diabetic ketoacidosis without coma
Excludes
- Hyperosmolar hyperglycemic state (E11.01)
Clinical Validation Requirements
- pH <7.3
- Serum bicarbonate <18 mEq/L
- Presence of ketones
Coding Notes
Ensure documentation of acidosis and ketone levels.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Hyperglycemic Crisis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.01.
Impact
Clinical: Misrepresents the severity of the condition., Regulatory: May lead to compliance issues during audits., Financial: Results in incorrect reimbursement.
Mitigation Strategy
Ensure lab values support the chosen code., Differentiate based on clinical criteria.
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: May result in audit issues if documentation does not support the code., Data Quality: Affects clinical data accuracy and patient records.
Mitigation Strategy
Differentiate based on lab values and presence of ketones or coma.
Impact
Using codes without supporting documentation.
Mitigation Strategy
Regular training on documentation and 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 Hyperglycemic Crisis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hyperglycemic Crisis
Use these documentation templates to ensure complete and accurate documentation for Hyperglycemic Crisis. These templates include all required elements for proper coding and billing.
Emergency Department Admission for Hyperglycemic Crisis
Specialty: Emergency MedicineRequired Elements
- Patient history
- Lab results
- Mental status
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Hyperglycemic Crisis? Ask your questions below.