ICD-10 Coding for ICD-10-CM(E11.9)
Complete ICD-10-CM coding and documentation guide for ICD-10-CM. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to ICD-10-CM
A00-Z99Primary Range
ICD-10-CM code range for all diseases and conditions
This range includes all ICD-10-CM codes used for diagnosis coding in healthcare settings.
Key Information: What does ICD-10-CM stand for?
Essential facts and insights about ICD-10-CM
Primary ICD-10-CM Code for what does icd 10 cm stand for
Decision Criteria
clinical Criteria
- Patient diagnosed with type 2 diabetes without complications.
Applicable To
- Type 2 diabetes mellitus
Excludes
- Type 1 diabetes mellitus (E10.-)
Clinical Validation Requirements
- Diagnosis of diabetes type 2 confirmed by lab tests
- Absence of complications
Code-Specific Risks
- Ensure specificity to avoid using unspecified codes.
Coding Notes
- Ensure to document the type of diabetes and any associated treatments.
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-CM 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 claim denials.
Mitigation Strategy
Always specify the type of diabetes, Include treatment and complication details
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts the accuracy of health data.
Mitigation Strategy
Always code to the highest level of specificity.
Impact
High use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure all codes are as specific as possible.
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-CM, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for ICD-10-CM
Use these documentation templates to ensure complete and accurate documentation for ICD-10-CM. These templates include all required elements for proper coding and billing.
Diabetes Management
Specialty: EndocrinologyRequired Elements
- Type of diabetes
- Current treatment regimen
- Recent lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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