ICD-10 Coding for Diabetes Mellitus with Hypoglycemia(E11.64)
Complete ICD-10-CM coding and documentation guide for Diabetes Mellitus with Hypoglycemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetes Mellitus with Hypoglycemia
E11.64Primary Range
Type 2 diabetes mellitus with hypoglycemia
Primary code for Type 2 diabetes with hypoglycemia
Long-term (current) use of oral hypoglycemic drugs
Used when patient is on long-term oral hypoglycemic therapy
Key Information: ICD-10 code for diabetes mellitus with hypoglycemia
Essential facts and insights about Diabetes Mellitus with Hypoglycemia
Primary ICD-10-CM Code for initials of a doctor with hypoglycemia
Decision Criteria
clinical Criteria
- Hypoglycemia linked to diabetes with glucose <70 mg/dL
coding Criteria
- Use E16.A codes to specify hypoglycemia level
Applicable To
- Type 2 diabetes with hypoglycemia
Excludes
- Hypoglycemia without diabetes (E16.2)
Clinical Validation Requirements
- Documented hypoglycemia with glucose <70 mg/dL
- Linkage to diabetes mellitus
Code-Specific Risks
- Incorrectly coding without specifying hypoglycemia level
Coding Notes
- Ensure documentation specifies the level of hypoglycemia
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.
Hypoglycemia, unspecified
E16.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetes Mellitus with Hypoglycemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.64.
Impact
Clinical: May lead to inadequate treatment adjustments, Regulatory: Fails to meet documentation standards, Financial: Potential for incorrect billing
Mitigation Strategy
Specify control status, Include glucose readings
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use E11.64 for diabetes with hypoglycemia
Impact
Inadequate documentation of hypoglycemia levels
Mitigation Strategy
Ensure detailed documentation of glucose levels and symptoms
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 Diabetes Mellitus with Hypoglycemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetes Mellitus with Hypoglycemia
Use these documentation templates to ensure complete and accurate documentation for Diabetes Mellitus with Hypoglycemia. These templates include all required elements for proper coding and billing.
Type 2 DM with hypoglycemia
Specialty: EndocrinologyRequired Elements
- Type of diabetes
- Hypoglycemia level
- Current medications
- Blood glucose readings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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