The fourth digit identifies whether clinically significant manifestations exist and, if so, which body system is affected. The first three digits are the diagnostic code category 250, indicating diabetes mellitus. You have to document very specifically and consistently if you and your staff are going to choose the right one. KEY WORDS: Complication – A condition that aggravates an existing disease Manifestation – A condition/disease that is caused by another disease OGCR – 2021 ICD-10-CM Official Guidelines for Coding and Reporting.įor more information on coding, auditing, and cancer registry, check out the MRA website here.There are nearly 40 ICD-9 codes for reporting diabetes disease processes. Complications/manifestations of DM, as well as use of insulin, oral, and other injectable medications use to treat DM will be covered in future blogs along with review of the specific ICD-10-CM codes that should be assigned. SUMMARY: While briefly mentioning the complications of primary diabetes mellitus (DM) and manifestations of the disease, this blog concentrates on ICD-10-CM code assignments and coding guidelines for primary diabetes mellitus (DM) – Types 1, 1.5, and 2. Coders are reminded to always review the provider’s documentation, in addition to thoroughly reading all includes, excludes, and other instructional notes found under category codes E08 – E13 in the classification itself. Information on assigning ICD-10-CM codes tor DM Types 1, 1.5, and 2. People with type 1.5 diabetes have autoantibodies to insulin-producing beta cells and gradually lose their insulin-producing capability, requiring insulin within 5-10 years of diagnosis.” These patients have also been described with the terms “latent autoimmune diabetes of adults” (LADA), and “slow-progressing type 1 diabetes.” The condition has also been called “double” diabetes because individuals demonstrate both the autoimmune destruction of beta cells of type 1 diabetes and the insulin resistance characteristic of type 2 diabetes. The AHA Coding Clinic for ICD-9-CM and ICD-10-CM/PCS ©, 3Q 2018 (pages 4-5) recommends assigning code(s) from category E13, Other specified diabetes mellitus, for Type 1.5: “ Type 1.5 diabetes is a form of diabetes in which an adult has features of both type 1 and type 2 diabetes. It has been my experience that the ICD-10 classification system can lag several years behind medical advances and changes to medical diagnoses and treatments. Unlike Types 1 and 2, there is no specific category code for Type 1.5 DM. Type 2 (like Type 1) ophthalmic complications require a coder-selected seventh digit.Depending on the circumstances (and documentation) coding arthropathy, and skin complications requires six digits.Fourth and fifth digits address complications related to hyperosmolarity, ketoacidosis, kidney, neurologic, and circulatory systems, and hyperglycemia.

Ophthalmic complications are further specified via coder-selected seventh digits.ĬODING TYPE 2 DM – Assign a code from category E10.Fourth, fifth-, and sixth-digit assignments address complications like ketoacidosis kidney, ophthalmic, neurologic, circulatory, and “other specified” complications like diabetic arthropathy, skin, oral complications, hypo- and hyperglycemia.Assign a code from category E11 – Type 2 DM should the record fail to document the type of DMĬODING TYPE 1 DM – Assign a code from category E10.Sequence the codes based on the reason for that specific encounter and.Assign as many codes within a category as are needed in order to adequately reflect all documented complications.The guideline states that the coder should: The complications affecting specific body systems.The body systems affected, in addition to.OGCR 1.C.4.a specifically addresses DM, noting the codes are combination codes that: In examining code assignments for DM Types 1, 1.5, and 2, where might you start? Well, let us turn to the 2021 ICD-10-CM OGCR – the Official Guidelines for Coding & Reporting. Realizing the importance of fully comprehending the pathophysiology of secondary diabetes as well as all diabetic complications and manifestations, future blogs will delve into of these topics.ĭM has five category codes in ICD-10-CM – category codes are E08 – E13. Today, we’ll concentrate on ICD-10-CM codes for Types 1, 1.5, and 2. Diabetes can also manifest into other conditions like retinopathy, skin ulcers, and nephropathy. There are other forms of DM that are due to underlying conditions or are “induced” by drugs or chemicals.Ĭomplications of primary DM include: hyperglycemia, hypoglycemia, HHS (diabetic hyperglycemia hyperosmolar state) DKA and hyponatremia with diabetic hyperglycemia. Types 1 and 2 (and even 1.5, though not “officially” recognized) are considered primary types of DM. My first blog on Diabetes Mellitus (DM) covered the pathophysiology of DM Types 1, 1.5, and 2.

Icd 10 code for dm1