Health Information Management

Q&A: Coding for diabetes in ICD-10-CM

JustCoding News: Outpatient, November 16, 2011

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QUESTION: How will coding for diabetes change in ICD-10-CM?

ANSWER: In ICD-10-CM, the diabetes mellitus codes are combination codes that include the:

  • Type of diabetes
  • Body system affected
  • Complications affecting that body system

These combination codes make coding diabetes mellitus less confusing and decrease the number of codes necessary to describe diabetic complications. Coders may report as many combination codes as needed to fully describe all complications. Coders should sequence the codes based on the reason for a particular encounter.

In ICD-10-CM, the diabetes mellitus codes are no longer classified as controlled or uncontrolled. If provider documentation includes words such as uncontrolled, out of control, or poorly controlled, coders should report the type of diabetes with hyperglycemia.

In ICD-10-CM, diabetes mellitus falls under these five categories:

  • E08 – Diabetes mellitus due to underlying condition
  • E09 – Drug or chemical induced diabetes mellitus
  • E10 – Type 1 diabetes mellitus
  • E11 – Type 2 diabetes mellitus
  • E13 – Other specified diabetes mellitus

Category O24 identifies diabetes mellitus in pregnancy, childbirth, or the puerperium.

Some ICD-10-CM diabetes mellitus code examples include:

  • E09.01 – Drug or chemical induced diabetes mellitus with hyperosmolarity with coma
  • E10.11 – Type 1 diabetes mellitus with ketoacidosis with coma
  • E11.40 – Type 2 diabetes mellitus with diabetic nephropathy, unspecified
  • E13.621 – Other specified diabetes mellitus with foot ulcer

Editor’s Note: Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, director of HIM and coding at HCPro Inc., in Danvers, MA, answered this question.

This answer was provided based on limited information that was submitted to JustCoding.com. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

Need expert coding advice? Submit your question to Senior Managing Editor Michelle Leppert, CPC-A, at mleppert@hcpro.com, and we’ll do our best to get an answer for you.



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