About Diabetes Mellitus
Diabetes mellitus is a condition in which the blood glucose level is high. One reason behind the high glucose level is because of inadequate insulin production or the body’s cells not responding to insulin. Insulin is a hormone that is produced by the pancreas. Diabetes is a metabolism disorder. There are tests for determining whether the patient has prediabetes (R73.0) or diabetes (E10-E13). The tests are A1C test, Fasting Plasma Glucose (FPG) Test and the oral glucose tolerance test (OGTT).
Types of diabetes:
1. Type 1 diabetes (E10+):
? Also known as Insulin-dependent diabetes, Juvenile diabetes and early-onset diabetes. This type of diabetes lasts for the patient?s life. The treatment involves regular insulin injections, diet and exercise.
? Symptoms include :
? Lethargy
? Stupor
? Weight loss
? Hyperventilation
? Nausea
? Vomiting
? Abdominal pain
2. Type 2 diabetes (E11+)
? In type 2 diabetes, the body does not react to insulin. Type 2 diabetes can be controlled by losing weight, exercising, and a healthy diet. But sometimes insulin injections are required to maintain optimum blood glucose levels. Patients can have prediabetes (R73.0) this means the blood glucose levels are higher than normal, but does not qualify for diabetes yet, however if the blood glucose levels rise the patient will move into Type 2 diabetes.
3. Gestational diabetes (O24.4+)
? Gestational diabetes is a condition that occurs during pregnancy. The levels of glucose in blood are very high and hence the body is unable to produce enough insulin to transport all of the glucose into their cells. Exercising and healthy diet can help in controlling gestational diabetes.
If diabetes is not controlled they can lead to serious complications:
? Eye complications
? Foot complications
? Skin complications
? Heart problems
? Hypertension
? Mental health
? Hearing loss
? Gum disease
? Gastroparesis
? Ketoacidosis
? Neuropathy
? Hyperosmolar Hyperglycemic Nonketotic Syndrome(HHNS)
? Nephropathy
? Peripheral Arterial Disease(PAD)
? Stroke
? Erectile dysfunction
? Infections
? Healing of wounds
In ICD-10-CM, chapter 4, “Endocrine, nutritional and metabolic diseases (E00-E89),” includes a separate subchapter for Diabetes mellitus E08-E13, with the categories:
? Diabetes mellitus due to underlying condition E08.
? Drug or chemical induced diabetes mellitus E09.
? Type 1 diabetes mellitus E10.
? Type 2 diabetes mellitus E11.
? Other specified diabetes mellitus E13.
The diabetes mellitus categories E08?E13 are further subdivided into four- or five-character subcategories. When a category has been subdivided into four-, five-, or six-character codes, the diabetes code assigned represents the highest level of specificity within ICD-10-CM.
Diabetes mellitus (DM) codes in ICD-10-CM are combination codes that include:
? The type
? The body system affected
? The complication affecting the body system.
? Subcategory includes the type of complication by system
? Kidney complications
? Ophthalmic complications
? Neurological complications and
? Circulatory complications.
? The particular manifestation is described in the further subclassified level.
Other specified complications are also provided that includes with diabetic neuropathic arthropathy , diabetic dermatitis, foot ulcer, periodontal disease, hypoglycemia and hyperglycemia. The ICD-10-CM has provided many codes to describe all the associated complications, hence there is no instructional note needed for the use of additional code for identifying the manifestation. However, an exception to this is diabetes with foot ulcer. To code this, an additional code is required to identify the manifestation. The code reported for Type I Diabetes with foot ulcer is E10.621.This code requires additional code to identify the site of the ulcer (L97.4-, L97.5-). One important note in ICD-10-CM is there is no additional code required for stating whether the diabetes is controlled or uncontrolled. If the documentation states poorly controlled, out of control or inadequately controlled, then these cases are reported diabetes (by type) with hyperglycemia. E11.65 is an example for this case.
Reviewing proper diabetes coding under ICD-10-CM will help you to maintain accurate knowledge and gain competent coding confidence.