ICD-10 Guide

Prediabetes

ICD-10 Coding for Prediabetes(R73.03, R73.09)

PRIMARY SPECIALTYEndocrinology

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Prediabetes?

Essential facts and insights about Prediabetes

Key Clinical Considerations:

Increased thirst and frequent urination
Fasting blood glucose levels of 100-125 mg/dL
Impaired glucose tolerance test results (140-199 mg/dL after 2 hours)

Clinical Information

Clinical Criteria & Documentation Requirements

Patient's medical history and risk factors
Results of blood glucose tests
Assessment of lifestyle factors (diet, exercise)

Coding Guidelines

Usage Guidelines & Examples

Follow guidelines for coding prediabetes versus diabetes.
Common errors include misclassifying prediabetes as diabetes.

Code Exclusions

Important Exclusions

Type 1 and Type 2 diabetes
Gestational diabetes

Specialty Focus

Primary Specialty

Endocrinology

Specialty Applications

Adults aged 45 and older, or younger adults with risk factors
Endocrinology clinics, primary care settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document patient's risk factors, test results, and any interventions.

What are the billing considerations?

Ensure accurate coding to reflect prediabetes for appropriate reimbursement.

Prediabetes

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What are the documentation requirements?

What are the billing considerations?

Prediabetes

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What are the documentation requirements?

What are the billing considerations?