Metabolic disorders

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 E70-E88 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 specify the type of diabetes (Type 1, Type 2, gestational, etc.) in the patient's medical record.
• •Include the control status (controlled or uncontrolled) when coding for diabetes.
• •Use combination codes to accurately represent diabetes with associated complications.
• •For drug-induced diabetes, specify the drug causing the condition.
• •In case of gestational diabetes, include the trimester in the documentation.

When to Use:

• ✓When a patient is diagnosed with any type of diabetes.
• ✓When a patient with diabetes presents with complications such as retinopathy, nephropathy, or neuropathy.
• ✓When a patient's diabetes is induced by a specific drug.
• ✓When a pregnant woman is diagnosed with gestational diabetes.

When NOT to Use:

• ✗When a patient has prediabetes or impaired glucose tolerance, these conditions have their own specific codes.
• ✗When a patient has secondary diabetes caused by another condition such as Cushing's syndrome or cystic fibrosis.
• ✗When a patient has neonatal diabetes, which is coded separately.
• ✗When a patient has transient diabetes.

Common Documentation Errors:

• ⚠Not specifying the type of diabetes
• ⚠Not including the control status
• ⚠Not documenting associated complications
• ⚠Not specifying the drug in case of drug-induced diabetes