ICD-10 Coding for Type 2 Diabetes Mellitus, Insulin Dependent(E11.9, E11.65)
Complete ICD-10-CM coding and documentation guide for Type 2 Diabetes Mellitus, Insulin Dependent. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Type 2 Diabetes Mellitus, Insulin Dependent
E11.0-E11.9Primary Range
Type 2 Diabetes Mellitus
This range covers all manifestations of type 2 diabetes, including those with insulin dependence.
Long-term (current) use of insulin
Used to indicate chronic insulin use in type 2 diabetes patients.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.9 | Type 2 diabetes mellitus without complications | Use when type 2 diabetes is diagnosed without any complications. |
|
| E11.65 | Type 2 diabetes mellitus with hyperglycemia | Use when hyperglycemia is documented in a type 2 diabetes patient. |
|
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 insulin-dependent type 2 diabetes
Essential facts and insights about Type 2 Diabetes Mellitus, Insulin Dependent
Primary ICD-10-CM Codes for type 2 diabetes insulin dependent
Decision Criteria
clinical Criteria
- Patient has type 2 diabetes without complications.
Applicable To
- Type 2 diabetes mellitus NOS
Clinical Validation Requirements
- Diagnosis of type 2 diabetes
- Absence of documented complications
Code-Specific Risks
- Misclassification if complications are present but not documented.
Coding Notes
- Ensure no complications are documented before using E11.9.
E11.65 - Type 2 diabetes mellitus with hyperglycemia
Use when hyperglycemia is documented in a type 2 diabetes patient.
Applicable To
- Type 2 diabetes with hyperglycemia
Excludes
- Diabetes mellitus due to underlying condition with hyperglycemia (E08.65)
- Drug or chemical induced diabetes mellitus with hyperglycemia (E09.65)
Clinical Validation Requirements
- Diagnosis of type 2 diabetes
- Documented hyperglycemia
Coding Notes
Document hyperglycemia to justify this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of insulin
Z79.4Differential 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 Type 2 Diabetes Mellitus, Insulin Dependent to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.9.
Impact
Clinical: Inaccurate treatment records., Regulatory: Potential non-compliance with coding standards., Financial: Possible claim denials.
Mitigation Strategy
Regularly update patient records with insulin details., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Only use Z79.4 for chronic insulin use.
Impact
Risk of audits due to lack of detailed insulin use documentation.
Mitigation Strategy
Implement documentation templates and regular audits.
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 2 Diabetes Mellitus, Insulin Dependent, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Type 2 Diabetes Mellitus, Insulin Dependent
Use these documentation templates to ensure complete and accurate documentation for Type 2 Diabetes Mellitus, Insulin Dependent. These templates include all required elements for proper coding and billing.
Endocrinology Visit
Specialty: EndocrinologyRequired Elements
- Patient adherence to insulin regimen
- Recent HbA1c levels
- Current insulin dosage
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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