ICD-10 Coding for Ketoacidosis(E10.10, E11.10, O24.419)
Complete ICD-10-CM coding and documentation guide for Ketoacidosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ketoacidosis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E10.10 | Type 1 diabetes mellitus with ketoacidosis without coma | Use when Type 1 diabetes is documented with ketoacidosis without coma. |
|
| E11.10 | Type 2 diabetes mellitus with ketoacidosis without coma | Use when Type 2 diabetes is documented with ketoacidosis without coma. |
|
| O24.419 | Gestational diabetes mellitus in pregnancy, unspecified control, with ketoacidosis | Use for gestational diabetes with ketoacidosis. |
|
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 ketoacidosis
Essential facts and insights about Ketoacidosis
Primary ICD-10-CM Codes for ketoacidosis
Decision Criteria
clinical Criteria
- Documented Type 1 diabetes with lab-confirmed ketoacidosis.
E11.10 - Type 2 diabetes mellitus with ketoacidosis without coma
Use when Type 2 diabetes is documented with ketoacidosis without coma.
Applicable To
- Type 2 diabetes with ketoacidosis
Excludes
- Type 1 diabetes with ketoacidosis (E10.10)
Clinical Validation Requirements
- Explicit statement linking DKA to Type 2 diabetes
Coding Notes
Sequence before infection codes if causal.
O24.419 - Gestational diabetes mellitus in pregnancy, unspecified control, with ketoacidosis
Use for gestational diabetes with ketoacidosis.
Applicable To
- Gestational diabetes with ketoacidosis
Excludes
- Pre-existing diabetes with ketoacidosis (E10-E14)
Clinical Validation Requirements
- Pregnancy status with gestational diabetes and ketoacidosis
Coding Notes
Never use E10-E13 codes with this code.
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 Ketoacidosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E10.10.
Impact
Clinical: Ambiguous treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify diabetes type., Include lab results confirming ketoacidosis.
Impact
Reimbursement: Incorrect reimbursement due to wrong DRG assignment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use E10.10 for Type 1 diabetes with ketoacidosis.
Impact
Coding the wrong diabetes type can lead to audit findings.
Mitigation Strategy
Verify diabetes type in documentation before coding.
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 Ketoacidosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ketoacidosis
Use these documentation templates to ensure complete and accurate documentation for Ketoacidosis. These templates include all required elements for proper coding and billing.
Emergency Department Note for DKA
Specialty: Emergency MedicineRequired Elements
- Diabetes Type
- DKA Confirmation
- Trigger Identified
- Neurologic Status
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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