ICD-10 Coding for Type 2 Diabetes Mellitus Without Complications(E11.9)
Complete ICD-10-CM coding and documentation guide for Type 2 Diabetes Mellitus Without Complications. 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 Without Complications
E11-E11.9Primary Range
Type 2 Diabetes Mellitus
This range includes codes for Type 2 Diabetes Mellitus, with E11.9 specifically for cases without complications.
Key Information: ICD-10 code for type 2 diabetes mellitus without complications
Essential facts and insights about Type 2 Diabetes Mellitus Without Complications
Primary ICD-10-CM Code for type 2 diabetes mellitus without complication
Decision Criteria
clinical Criteria
- Patient has stable Type 2 diabetes with no complications and controlled blood glucose levels.
documentation Criteria
- Documentation must specify 'without complications' and include recent lab results.
Applicable To
- Type 2 diabetes mellitus without any complications
Clinical Validation Requirements
- HbA1c ≤7%
- Fasting glucose ≤130 mg/dL
- No evidence of end-organ damage
Code-Specific Risks
- Misclassification if complications are present but not documented
- Incorrect use if hyperglycemia is present
Coding Notes
- Ensure documentation clearly states 'Type 2 diabetes mellitus without complications' and includes recent lab results supporting the absence of complications.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Type 2 Diabetes Mellitus Without Complications to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.9.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always document the specific type of diabetes., Include control status and lab results.
Impact
Reimbursement: Incorrect coding can lead to underpayment., Compliance: May result in audit failures., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Thoroughly review patient records for any signs of complications and document them appropriately.
Impact
Risk of audits if complications are present but not documented.
Mitigation Strategy
Regularly review and update patient records to accurately reflect the presence or absence of complications.
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 Without Complications, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Type 2 Diabetes Mellitus Without Complications
Use these documentation templates to ensure complete and accurate documentation for Type 2 Diabetes Mellitus Without Complications. These templates include all required elements for proper coding and billing.
Routine follow-up for Type 2 Diabetes Mellitus
Specialty: Primary CareRequired Elements
- Patient's diabetes type
- Control status
- Recent lab results
- Absence of complications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Type 2 Diabetes Mellitus Without Complications? Ask your questions below.