ICD-10 Coding for ICD-10 Coding(E11.9)
Complete ICD-10-CM coding and documentation guide for ICD-10 Coding. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to ICD-10 Coding
Key Information: What is ICD-10 coding?
Essential facts and insights about ICD-10 Coding
Primary ICD-10-CM Code for what are icd-10
Decision Criteria
clinical Criteria
- Patient diagnosed with type 2 diabetes and no complications present.
Applicable To
- Type 2 diabetes mellitus
Excludes
- Type 1 diabetes mellitus (E10.-)
Clinical Validation Requirements
- HbA1c ≥6.5%
- Fasting glucose ≥126 mg/dL
Code-Specific Risks
- Risk of unspecified coding if complications are present but not documented.
Coding Notes
- Ensure to document the absence of complications explicitly to use 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.
Type 1 diabetes mellitus without complications
E10.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting ICD-10 Coding to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.9.
Impact
Clinical: Lack of detailed patient information., Regulatory: Potential audit issues., Financial: Reduced reimbursement rates.
Mitigation Strategy
Always verify documentation for specificity., Use the Tabular Index for final code selection.
Impact
Reimbursement: Incorrect sequencing can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Poor data quality affecting clinical records.
Mitigation Strategy
Always sequence etiology codes before manifestation codes.
Impact
Risk of using unspecified codes.
Mitigation Strategy
Ensure detailed documentation and use of specific codes.
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 ICD-10 Coding, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for ICD-10 Coding
Use these documentation templates to ensure complete and accurate documentation for ICD-10 Coding. These templates include all required elements for proper coding and billing.
Diabetes management visit
Specialty: EndocrinologyRequired Elements
- Patient history
- Medication list
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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