P40-P136
Medium Complexity

Other disorders originating in the perinatal period

Primary Specialty: Endocrinology
Last Updated: 2025-09-10

ICD-10 Codes (0)

0 billable
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Updates & Changes

FY 2026 Updates

Current Year

New Codes (1)

P04.49
Newborn affected by maternal use of other drugs of addiction

Revised Codes (1)

P04.17
Newborn affected by maternal use of cocaine - updated neonatal abstinence syndrome correlation

Deleted Codes

No codes deleted in this range for FY 2026

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 P40-P136 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

high priority

The E08-E13 range in the ICD-10 covers all forms of Diabetes Mellitus, including Type 1, Type 2, gestational, and drug-induced diabetes. These codes are used to document both the type of diabetes and any complications or manifestations associated with the disease. The range also distinguishes between controlled and uncontrolled diabetes, allowing for more precise documentation and treatment planning.

Key Usage Points:

  • E08-E13 codes should always specify the type of diabetes.
  • Complications and manifestations should be coded separately, but within the E08-E13 range.
  • Controlled and uncontrolled diabetes have different codes within this range.
  • Combination codes are available for certain complications.
  • Always code to the highest level of specificity within the E08-E13 range.

Coding Guidelines

When to Use:

  • When a patient has been diagnosed with any form of diabetes.
  • When a patient with diabetes presents with complications or manifestations of the disease.
  • When a patient's diabetes is either controlled or uncontrolled.
  • When a patient with diabetes has multiple complications that can be represented with a combination code.

When NOT to Use:

  • When a patient is at risk for diabetes but has not been officially diagnosed.
  • When a patient has a complication or manifestation not directly related to their diabetes.
  • When a patient's diabetes control status is unknown or not documented.
  • When a patient's diabetes-related complication cannot be accurately represented with a combination code.

Code Exclusions

Always verify exclusions with the latest ICD-10 guidelines and updates.

Documentation Requirements

Proper documentation for the E08-E13 range requires specific information about the patient's diabetes. This includes the type of diabetes, any complications or manifestations, and the control status of the disease.

Clinical Information:

  • Type of diabetes
  • Presence of complications or manifestations
  • Control status of diabetes
  • Relevant medical history
  • Current treatment plan

Supporting Evidence:

  • Lab results confirming diagnosis
  • Physician's notes on complications or manifestations
  • Medication records indicating control status
  • Patient's self-reported symptoms and experiences
Good Documentation Example:

Patient has Type 2 diabetes, controlled with metformin. Presents with diabetic neuropathy in the lower extremities.

Poor Documentation Example:

Patient has diabetes.

Common Documentation Errors:

  • Not specifying the type of diabetes
  • Failing to document complications or manifestations
  • Not indicating control status
  • Using non-specific codes when specific codes are available

Range Statistics

7
Total Codes
0
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:16

Coding Complexity

Medium
Complexity Rating

The E08-E13 range has a medium complexity due to the need to accurately identify the type of diabetes, any complications or manifestations, and the control status. Additionally, the use of combination codes can add complexity.

Key Factors:
  • Determining the specific type of diabetes
  • Identifying and coding for complications and manifestations
  • Determining control status
  • Using combination codes when appropriate

Specialty Focus

The E08-E13 range is most commonly used by endocrinologists and primary care physicians. However, any specialty treating patients with diabetes may use these codes.

Primary Specialties:
Endocrinology
60%
Primary Care
30%
Clinical Scenarios:
  • A patient with Type 1 diabetes presents with diabetic retinopathy.
  • A patient with Type 2 diabetes has uncontrolled blood sugar levels.
  • A pregnant patient develops gestational diabetes.
  • A patient with diabetes presents with kidney complications.
  • A patient's diabetes is controlled with insulin.

Resources & References

Several resources are available to assist with coding in the E08-E13 range. These include the official ICD-10 guidelines, clinical references, and educational materials.

Official Guidelines:

  • ICD-10-CM Official Guidelines for Coding and Reporting
  • American Diabetes Association Clinical Practice Recommendations
  • World Health Organization ICD-10 Guidelines

Clinical References:

  • American Diabetes Association Standards of Medical Care in Diabetes
  • Endocrine Society Clinical Practice Guidelines

Educational Materials:

  • American Health Information Management Association (AHIMA) ICD-10 Training
  • American Academy of Professional Coders (AAPC) ICD-10 Resources

Frequently Asked Questions

How do I code for a patient with multiple complications from diabetes?

Use a combination code if one is available that accurately represents the patient's condition. If not, code each complication separately within the E08-E13 range.