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ICD-10 Coding for Type 1 Diabetes Mellitus(E10.9, E10.621)

Complete ICD-10-CM coding and documentation guide for Type 1 Diabetes Mellitus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Insulin-dependent diabetesJuvenile diabetesInsulin-Dependent Diabetes Mellitus (IDDM)insulin-dependent diabetes mellitus

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Related ICD-10 Code Ranges

Complete code families applicable to Type 1 Diabetes Mellitus

E10Primary Range

Type 1 Diabetes Mellitus

This range covers all codes related to Type 1 Diabetes Mellitus, including complications and specific conditions.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
E10.9Type 1 diabetes mellitus without complicationsUse when no complications are documented or treated during the encounter.
  • Diagnosis of Type 1 diabetes confirmed by C-peptide test or autoantibody testing
E10.621Type 1 diabetes mellitus with foot ulcerUse when a foot ulcer is present and related to Type 1 diabetes.
  • Presence of foot ulcer confirmed by clinical examination

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 Type 1 Diabetes

Essential facts and insights about Type 1 Diabetes Mellitus

The ICD-10 code for Type 1 Diabetes Mellitus without complications is E10.9. For complications, use specific codes like E10.621.

Primary ICD-10-CM Codes for initials of a doctor type 1

E10.9
Type 1 diabetes mellitus without complications
Billable Code

Decision Criteria

clinical Criteria

  • Confirmed diagnosis of Type 1 diabetes without acute or chronic complications

Applicable To

  • Type 1 diabetes mellitus NOS

Excludes

  • Type 2 diabetes mellitus (E11.-)

Clinical Validation Requirements

  • Diagnosis of Type 1 diabetes confirmed by C-peptide test or autoantibody testing

Code-Specific Risks

  • Misclassification if complications are present but not documented

Coding Notes

  • Ensure documentation clearly states 'Type 1' to avoid confusion with Type 2 diabetes.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Long term (current) use of insulin

Z79.4
Use to indicate ongoing insulin therapy.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Type 2 diabetes mellitus without complications

E11.9
Type 2 diabetes is typically non-insulin dependent and occurs in adults.

Type 2 diabetes mellitus with foot ulcer

E11.621
Differentiate based on the type of diabetes.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Type 1 Diabetes Mellitus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E10.9.

Impact

Clinical: Incomplete treatment record, Regulatory: Non-compliance with documentation standards, Financial: Potential denial of claims

Mitigation Strategy

Always document insulin therapy, Use Z79.4 for long-term insulin use

Impact

Reimbursement: Potential underpayment due to lack of specificity, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation

Mitigation Strategy

Review documentation for any complications and use specific codes like E10.621.

Impact

High error rate in coding diabetes complications

Mitigation Strategy

Regular training on documentation and coding updates

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 Type 1 Diabetes Mellitus, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Type 1 Diabetes Mellitus

Use these documentation templates to ensure complete and accurate documentation for Type 1 Diabetes Mellitus. These templates include all required elements for proper coding and billing.

Routine follow-up for Type 1 Diabetes

Specialty: Endocrinology

Required Elements

  • Blood glucose levels
  • Insulin regimen
  • Complications assessment

Example Documentation

Patient with Type 1 diabetes, well-controlled on insulin. No complications noted.

Examples: Poor vs. Good Documentation

Poor Documentation Example
DM follow-up, stable.
Good Documentation Example
Type 1 diabetes follow-up: BG 120-150 mg/dL, on insulin, no complications.
Explanation
The good example provides specific details about the diabetes type, control status, and absence of complications.

Need help with ICD-10 coding for Type 1 Diabetes Mellitus? Ask your questions below.

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