ICD-10 Coding for Hypoglycemia(E16.2, E16.A1)
Complete ICD-10-CM coding and documentation guide for Hypoglycemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypoglycemia
E16.0-E16.9Primary Range
Other disorders of pancreatic internal secretion
This range includes codes for hypoglycemia not associated with diabetes.
Type 2 diabetes mellitus with hypoglycemia
Used when hypoglycemia is a complication of 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 |
|---|---|---|---|
| E16.2 | Hypoglycemia, unspecified | Use when hypoglycemia is documented without a specified cause or level. |
|
| E16.A1 | Hypoglycemia, level 1 | Use as a secondary code when level 1 hypoglycemia is documented. |
|
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 hypoglycemia
Essential facts and insights about Hypoglycemia
Primary ICD-10-CM Codes for hypoglycemia
Decision Criteria
clinical Criteria
- Blood glucose level below 70 mg/dL with symptoms
Applicable To
- Hypoglycemia not otherwise specified
Excludes
- Hypoglycemia in diabetes (E11.64)
Clinical Validation Requirements
- Blood glucose level below 70 mg/dL
- Symptoms such as sweating, confusion, or tremors
Code-Specific Risks
- Risk of undercoding if level is documented but not coded
Coding Notes
- Always sequence E16.2 first when using level codes.
E16.A1 - Hypoglycemia, level 1
Use as a secondary code when level 1 hypoglycemia is documented.
Applicable To
- Mild hypoglycemia
Clinical Validation Requirements
- Blood glucose level between 54-70 mg/dL
Coding Notes
Ensure provider documentation specifies level 1.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Hypoglycemia, level 1
E16.A1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Type 2 diabetes mellitus with hypoglycemia
E11.64Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypoglycemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E16.2.
Impact
Clinical: Misrepresentation of patient condition, Regulatory: Potential audit issues, Financial: Incorrect billing and reimbursement
Mitigation Strategy
Educate providers on documentation requirements, Use templates to ensure completeness
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Always sequence E16.2 first, followed by level codes.
Impact
Failure to sequence E16.2 before level codes
Mitigation Strategy
Educate coders on proper sequencing rules
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 Hypoglycemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypoglycemia
Use these documentation templates to ensure complete and accurate documentation for Hypoglycemia. These templates include all required elements for proper coding and billing.
Hypoglycemia in a diabetic patient
Specialty: EndocrinologyRequired Elements
- Blood glucose level
- Symptoms
- Treatment provided
- Hypoglycemia level
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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