Neoplasms of unspecified behavior
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Updates & Changes
FY 2026 Updates
Deleted Codes
No codes deleted in this range for FY 2026
No significant changes for FY 2026
This range maintains stability with current coding practices
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for D49-D49 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range E08-E13 pertains to Diabetes Mellitus, a group of metabolic disorders characterized by high blood sugar levels over a prolonged period. This range covers all types of diabetes including Type 1, Type 2, gestational, and drug-induced diabetes. It also includes codes for various complications and manifestations associated with diabetes, such as diabetic retinopathy, nephropathy, neuropathy, and cardiovascular disease.
Key Usage Points:
- •E08-E13 codes are used to specify the type of diabetes and whether it is controlled or uncontrolled.
- •Complications and manifestations are coded using combination codes within this range.
- •E11.9 is the default code for Type 2 diabetes without complications.
- •E10.9 is the default code for Type 1 diabetes without complications.
- •Control status is not directly coded in ICD-10 but can be inferred from the presence of complications.
Coding Guidelines
When to Use:
- ✓When a patient has been diagnosed with any type of diabetes.
- ✓When a patient with diabetes presents with complications or manifestations.
- ✓When a patient's diabetes is a significant factor in their current medical condition.
- ✓When a patient's diabetes has been poorly controlled.
When NOT to Use:
- ✗When a patient has prediabetes or impaired glucose tolerance.
- ✗When a patient has a family history of diabetes but no personal diagnosis.
- ✗When a patient's blood sugar is temporarily elevated due to stress or illness.
- ✗When a patient has gestational diabetes, but it has resolved postpartum.
Code Exclusions
Always verify exclusions in the ICD-10 manual as they may change with updates.
Documentation Requirements
Proper documentation for diabetes coding should include the type of diabetes, the control status, and any complications or manifestations. The documentation should also specify whether the diabetes is insulin dependent.
Clinical Information:
- •Type of diabetes
- •Control status
- •Presence of complications or manifestations
- •Insulin dependence
Supporting Evidence:
- •Lab results showing blood glucose levels
- •Medical history
- •Physical examination findings
- •Medication records
Good Documentation Example:
Patient has Type 2 diabetes, poorly controlled, with diabetic neuropathy. On insulin.
Poor Documentation Example:
Patient has diabetes.
Common Documentation Errors:
- ⚠Not specifying the type of diabetes
- ⚠Not documenting complications or manifestations
- ⚠Not indicating control status
- ⚠Not indicating insulin dependence
Range Statistics
Coding Complexity
The complexity of coding diabetes lies in the need to accurately capture the type of diabetes, its control status, and any associated complications. This requires a thorough understanding of the disease and careful review of the medical record.
Key Factors:
- ▸Determining the type of diabetes
- ▸Identifying and coding complications
- ▸Determining control status
- ▸Identifying insulin dependence
Specialty Focus
Endocrinologists, primary care physicians, and ophthalmologists are among the specialties that frequently use the E08-E13 range.
Primary Specialties:
Clinical Scenarios:
- • A patient with Type 1 diabetes presents with diabetic ketoacidosis.
- • A patient with Type 2 diabetes has poorly controlled blood sugar and diabetic nephropathy.
- • A pregnant patient develops gestational diabetes.
- • A patient with diabetes has peripheral neuropathy and diabetic foot ulcer.
Resources & References
There are several resources available for coding diabetes, including the ICD-10 manual, coding clinics, and professional organizations.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- AHA Coding Clinic
- American Association of Professional Coders (AAPC)
Clinical References:
- American Diabetes Association
- National Institute of Diabetes and Digestive and Kidney Diseases
Educational Materials:
- AAPC ICD-10 Training
- AHIMA ICD-10 Training
Frequently Asked Questions
How do I code for a patient with Type 2 diabetes and diabetic retinopathy?
Use a combination code from the E11.3 subcategory. The fourth character indicates the type of retinopathy and the fifth character indicates whether it is with macular edema or proliferative retinopathy.