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ICD-10 Guide
ICD-10 CodesE16.0

E16.0

Billable

Drug-induced hypoglycemia without coma

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

Code Description

ICD-10 E16.0 is a billable code used to indicate a diagnosis of drug-induced hypoglycemia without coma.

Key Diagnostic Point:

Drug-induced hypoglycemia without coma refers to a condition where a patient experiences low blood glucose levels due to the administration of certain medications, without the presence of a coma. This condition is particularly relevant in patients with diabetes who are treated with insulin or oral hypoglycemic agents. The hypoglycemic episode can manifest with symptoms such as sweating, tremors, palpitations, and confusion. It is crucial to differentiate this condition from other causes of hypoglycemia, such as endogenous hyperinsulinism or pancreatic islet disorders, which may require different management strategies. The pathophysiology involves an imbalance in glucose metabolism, where the pharmacological effects of the drugs lead to excessive insulin secretion or increased sensitivity to insulin, resulting in decreased blood glucose levels. Proper management includes prompt recognition of symptoms, administration of glucose, and adjustment of medication regimens to prevent recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between drug-induced and other causes of hypoglycemia.
  • Understanding the specific medications that can lead to this condition.
  • Recognizing the symptoms and clinical presentation of hypoglycemia.
  • Documenting the absence of coma to ensure accurate coding.

Audit Risk Factors

  • Inadequate documentation of medication history.
  • Failure to specify the absence of coma.
  • Misclassification of hypoglycemia type.
  • Lack of clinical correlation between symptoms and diagnosis.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, including dosages and timing of administration.

Common Clinical Scenarios

Patients with diabetes experiencing hypoglycemia after insulin administration.

Billing Considerations

Ensure that the documentation clearly states the cause of hypoglycemia is drug-induced.

Internal Medicine

Documentation Requirements

Comprehensive review of patient history and current medications.

Common Clinical Scenarios

Patients presenting with symptoms of hypoglycemia without a known history of diabetes.

Billing Considerations

Documenting the clinical context and ruling out other causes of hypoglycemia.

Coding Guidelines

Inclusion Criteria

Use E16.0 When
  • According to ICD
  • 10 coding guidelines, E16
  • 0 should be used when hypoglycemia is directly attributed to drug use without coma
  • Coders must ensure that the documentation supports the diagnosis and that the condition is not due to other underlying issues

Exclusion Criteria

Do NOT use E16.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

83036CPT Code

Glucose; quantitative, blood (e.g., glucose tolerance test)

Clinical Scenario

Used in conjunction with E16.0 to monitor blood glucose levels.

Documentation Requirements

Document the reason for testing and the patient's clinical status.

Specialty Considerations

Endocrinologists may require more detailed documentation of glucose monitoring.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like drug-induced hypoglycemia, improving the accuracy of patient records and facilitating better management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like drug-induced hypoglycemia, improving the accuracy of patient records and facilitating better management strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like drug-induced hypoglycemia, improving the accuracy of patient records and facilitating better management strategies.

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 medications can cause drug-induced hypoglycemia?

Common medications include insulin, sulfonylureas, and meglitinides. It's important to review the patient's medication list to identify potential culprits.