ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesE16.1

E16.1

Billable

Other hypoglycemia

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

Code Description

ICD-10 E16.1 is a billable code used to indicate a diagnosis of other hypoglycemia.

Key Diagnostic Point:

Other hypoglycemia refers to a condition characterized by abnormally low levels of glucose in the blood that are not classified under specific categories such as diabetes-related hypoglycemia or fasting hypoglycemia. This condition can arise from various causes, including hyperinsulinism, which is an excessive secretion of insulin from the pancreas, often due to pancreatic islet disorders. These disorders can disrupt normal glucose metabolism, leading to episodes of hypoglycemia. Patients may present with symptoms such as sweating, tremors, confusion, and in severe cases, loss of consciousness. The diagnosis of other hypoglycemia requires careful evaluation of the patient's medical history, including medication use, dietary habits, and any underlying endocrine disorders. It is crucial to identify the underlying cause to manage the condition effectively, as treatment may involve dietary modifications, medication adjustments, or addressing the specific pancreatic disorder contributing to the hypoglycemic episodes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes that can lead to hypoglycemia.
  • Need for thorough patient history and diagnostic testing.
  • Differentiation from other types of hypoglycemia.
  • Potential for co-existing conditions that complicate diagnosis.

Audit Risk Factors

  • Inadequate documentation of the underlying cause of hypoglycemia.
  • Failure to document the patient's medication history.
  • Lack of clarity in distinguishing between different types of hypoglycemia.
  • Insufficient detail on the clinical presentation and symptoms.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed patient history, including medication use, dietary habits, and symptoms experienced during hypoglycemic episodes.

Common Clinical Scenarios

Patients with unexplained hypoglycemia, those with insulinomas, or patients on insulin therapy presenting with low blood sugar levels.

Billing Considerations

Endocrinologists must ensure that all potential causes of hypoglycemia are explored and documented to support the diagnosis.

Internal Medicine

Documentation Requirements

Comprehensive assessment of the patient's overall health, including any chronic conditions that may contribute to hypoglycemia.

Common Clinical Scenarios

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

Billing Considerations

Internal medicine physicians should consider a broad differential diagnosis and document all relevant findings.

Coding Guidelines

Inclusion Criteria

Use E16.1 When
  • According to ICD
  • 10 coding guidelines, E16
  • 1 should be used when hypoglycemia is not due to diabetes or other specified causes
  • Coders must ensure that the documentation supports the diagnosis and that other potential causes have been ruled out

Exclusion Criteria

Do NOT use E16.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

82947CPT Code

Glucose; quantitative, blood (serum, plasma)

Clinical Scenario

Used to confirm hypoglycemia in patients presenting with symptoms.

Documentation Requirements

Document the reason for the glucose test and any symptoms experienced.

Specialty Considerations

Endocrinologists may require additional tests to evaluate insulin levels.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hypoglycemia, enabling better tracking of cases and improved management of patients with complex conditions. E16.1 provides a distinct code for hypoglycemia not related to diabetes, which was less clearly defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hypoglycemia, enabling better tracking of cases and improved management of patients with complex conditions. E16.1 provides a distinct code for hypoglycemia not related to diabetes, which was less clearly defined in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hypoglycemia, enabling better tracking of cases and improved management of patients with complex conditions. E16.1 provides a distinct code for hypoglycemia not related to diabetes, which was less clearly defined in ICD-9.

Resources

Clinical References

  • •
    American Diabetes Association
  • •
    Centers for Disease Control and Prevention (CDC)

Coding & Billing References

  • •
    American Diabetes Association
  • •
    Centers for Disease Control and Prevention (CDC)

Frequently Asked Questions

What are the common causes of other hypoglycemia?

Common causes include hyperinsulinism, certain medications, hormonal deficiencies, and dietary factors. It is essential to evaluate each patient's history to identify the specific cause.

How can hypoglycemia be managed?

Management typically involves addressing the underlying cause, which may include dietary changes, medication adjustments, or treatment of any endocrine disorders contributing to hypoglycemia.