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v1.0.0
ICD-10 Guide
ICD-10 CodesE16.2

E16.2

Billable

Hypoglycemia, unspecified

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

Code Description

ICD-10 E16.2 is a billable code used to indicate a diagnosis of hypoglycemia, unspecified.

Key Diagnostic Point:

Hypoglycemia, or low blood sugar, is a condition characterized by abnormally low levels of glucose in the blood. It can occur in individuals with diabetes who are on insulin or other glucose-lowering medications, but it can also arise in non-diabetic individuals due to various causes. The symptoms of hypoglycemia can range from mild to severe and may include shakiness, sweating, confusion, irritability, and in extreme cases, loss of consciousness or seizures. The underlying mechanisms of hypoglycemia can involve excessive insulin production (hyperinsulinism), which may be due to pancreatic islet disorders, or inadequate glucose production by the liver. In some cases, hypoglycemia can be a result of certain medications, alcohol consumption, or prolonged fasting. Accurate diagnosis often requires a thorough clinical evaluation, including a detailed history of symptoms, dietary habits, and any underlying medical conditions. The unspecified nature of this code indicates that the specific cause of hypoglycemia has not been determined, necessitating further investigation to identify potential underlying disorders affecting glucose metabolism.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for detailed patient history
  • Differentiation from other metabolic disorders
  • Potential for misdiagnosis with other conditions

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify underlying causes
  • Lack of follow-up on hypoglycemic episodes
  • Misalignment between diagnosis and treatment provided

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed patient history, including medication use, dietary habits, and episodes of hypoglycemia.

Common Clinical Scenarios

Patients with diabetes experiencing recurrent hypoglycemic episodes, patients with suspected insulinomas.

Billing Considerations

Endocrinologists should document the frequency and severity of hypoglycemic events to support the diagnosis.

Primary Care

Documentation Requirements

Comprehensive assessment of symptoms and potential causes, including medication review.

Common Clinical Scenarios

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

Billing Considerations

Primary care providers should ensure thorough documentation to rule out other causes of hypoglycemia.

Coding Guidelines

Inclusion Criteria

Use E16.2 When
  • According to ICD
  • 10 coding guidelines, E16
  • 2 should be used when hypoglycemia is documented but the specific cause is not identified
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis

Exclusion Criteria

Do NOT use E16.2 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 glucose testing and any relevant clinical findings.

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 the condition and its causes. E16.2 provides a means to capture cases where the cause is not yet identified, which can aid in further clinical investigation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hypoglycemia, enabling better tracking of the condition and its causes. E16.2 provides a means to capture cases where the cause is not yet identified, which can aid in further clinical investigation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hypoglycemia, enabling better tracking of the condition and its causes. E16.2 provides a means to capture cases where the cause is not yet identified, which can aid in further clinical investigation.

Resources

Clinical References

  • •
    American Diabetes Association - Hypoglycemia

Coding & Billing References

  • •
    American Diabetes Association - Hypoglycemia

Frequently Asked Questions

What should I document to support the use of E16.2?

Document the patient's symptoms, any relevant medical history, and the results of blood glucose testing. If the cause of hypoglycemia is not identified, ensure that this is clearly stated in the documentation.