Diabetes mellitus

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 E08-E13 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...

Key Usage Points:

• •Always code for the type of diabetes first, followed by the complication or manifestation.
• •Use combination codes to represent diabetes with associated complications.
• •Distinguish between controlled and uncontrolled diabetes in your coding.
• •Remember to include gestational and drug-induced diabetes in this range.
• •When coding for diabetes, always consider the patient's current status and any associated conditions.

When to Use:

• ✓When a patient has been diagnosed with any type of diabetes.
• ✓When a patient with diabetes presents with a related complication.
• ✓When a patient's diabetes is uncontrolled.
• ✓When a patient has gestational or drug-induced diabetes.
• ✓When a patient has diabetes with an associated endocrine disorder.

When NOT to Use:

• ✗When a patient has prediabetes or impaired glucose tolerance.
• ✗When a patient has secondary diabetes due to another condition.
• ✗When a patient has a complication not directly related to their diabetes.
• ✗When a patient has a history of diabetes but no current diagnosis.
• ✗When a patient has neonatal diabetes.

Common Documentation Errors:

• ⚠Not specifying the type of diabetes
• ⚠Failing to document control status
• ⚠Not including associated complications
• ⚠Not updating the patient's current status