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The Coding of DM

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The Coding of DM
The coding of DM can be difficult
Learn to look for:
Various manifestations
Types—type 1 or type 2
Controlled or uncontrolled
Default is type 2 DM if Type of diabetes mellitus not documented
Use Z code for long-term use of insulin--Z79.4
Do not use Z code if insulin is temporarily given to control blood sugar

In ICD-10-CM there are 5 category codes for diabetes mellitus:
E08 Diabetes mellitus due to underlying condition (code underlying condition first)
E09 Drug or chemical induced diabetes mellitus
E10 Type I diabetes mellitus
E11 Type II diabetes mellitus
E13 Other specified diabetes mellitus

Out of control and poorly controlled diabetes are coded to the type of diabetes with hyperglycemia per the Alphabetic Index
E08.65
E09.65
E10.65
E11.65
E13.65
Diabetes mellitus (DM) complications
Metabolic
EG: Diabetic ketoacidosis--in Type I--E10.10--acidosis is not coded separately--it is a metabolic complication and is included in the code (Excludes 1 note)-p285 in text book
E08.10/11
E09.10/11
E10.10/11
E13.10/11

Manifestations--these are most common
Occurs in another body system--sometimes is included in DM code and sometimes you have to add additional code to ensure specificity of manifestation.
“Due to” DM
Before coding a diabetic manifestation, look for a direct cause and effect relationship. Specific to look for: manifestation must be documented as diabetic or be “due to” the diabetes.)Good example on bottom of page 287.
May need to query physician if diabetes and a condition that is often a diabetic manifestation are related , i.e. if there is a cause-and-effect relationship.

Review Exercise Question 15: Poorly controlled Diabetes (type 2) with diabetic gastroparesis. The directions on the review were incorrect--I have made a correction and it should be more clear now.
Review Exercise Question 19: Diabetes due to prednisone (sequela due to long term use of a prescribed drug). Error in answer key to

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