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ICD-10 Guide
ICD-10 CodesChapter 4: Endocrine, nutritional and metabolic diseasesE16

E16

Billable

Other disorders of pancreatic internal secretion

Chapter 4:Endocrine, nutritional and metabolic diseases

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E16 is a billable code used to indicate a diagnosis of other disorders of pancreatic internal secretion.

Key Diagnostic Point:

E16 encompasses a variety of conditions related to the dysfunction of pancreatic internal secretion, particularly those affecting insulin and glucose metabolism. This includes disorders such as hyperinsulinism, where excessive insulin secretion leads to hypoglycemia, and pancreatic islet disorders that disrupt normal glucose regulation. Patients may present with symptoms ranging from recurrent hypoglycemic episodes, characterized by sweating, palpitations, and confusion, to hyperglycemic states if insulin secretion is insufficient. The underlying pathophysiology often involves abnormalities in pancreatic islet cell function, which can be due to genetic factors, autoimmune processes, or other metabolic disturbances. Accurate diagnosis typically requires a combination of clinical evaluation, biochemical testing, and imaging studies to assess pancreatic function and structure. Understanding these disorders is crucial for effective management, which may include dietary modifications, medication, or surgical interventions in severe cases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to similar symptoms
  • Need for comprehensive documentation of clinical findings
  • Potential overlap with other endocrine disorders
  • Variability in treatment approaches based on specific diagnosis

Audit Risk Factors

  • Inadequate documentation of clinical symptoms
  • Failure to provide lab results supporting diagnosis
  • Misclassification of hypoglycemia causes
  • Lack of follow-up documentation for ongoing management

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed patient history, lab results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with unexplained hypoglycemia or hyperinsulinism.

Billing Considerations

Endocrinologists should ensure that all relevant tests are documented to support the diagnosis.

Internal Medicine

Documentation Requirements

Comprehensive assessment of metabolic status and any comorbid conditions.

Common Clinical Scenarios

Management of patients with diabetes and concurrent pancreatic disorders.

Billing Considerations

Internal medicine physicians should document any referrals to specialists for further evaluation.

Coding Guidelines

Inclusion Criteria

Use E16 When
  • According to ICD
  • 10 guidelines, E16 should be used when the specific disorder of pancreatic internal secretion is identified
  • It is important to document the underlying cause and any related conditions

Exclusion Criteria

Do NOT use E16 When
  • Exclusion criteria include conditions that are not primarily related to pancreatic secretion disorders

Related CPT Codes

82947CPT Code

Glucose; quantitative

Clinical Scenario

Used to confirm hypoglycemia in patients suspected of having E16.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Endocrinologists should correlate lab results with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of pancreatic disorders, improving the accuracy of diagnoses and treatment plans. E16 provides a distinct classification for disorders that were previously grouped under broader categories in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pancreatic disorders, improving the accuracy of diagnoses and treatment plans. E16 provides a distinct classification for disorders that were previously grouped under broader categories in ICD-9.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What conditions are included under E16?

E16 includes various disorders related to pancreatic internal secretion, such as hyperinsulinism and other pancreatic islet disorders affecting glucose metabolism.