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v1.0.0
ICD-10 Guide
DiagnosesType 2 Diabetes Mellitus Uncontrolled

Type 2 Diabetes Mellitus Uncontrolled

ICD-10 Coding for Uncontrolled Type 2 Diabetes Mellitus(E11.65, E11.649)

PRIMARY SPECIALTYEndocrinology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Type 2 Diabetes Mellitus Uncontrolled?
Essential facts and insights about Uncontrolled Type 2 Diabetes Mellitus

Key Clinical Considerations:

  • Increased thirst (polydipsia)
  • Frequent urination (polyuria)
  • Fatigue and weakness
  • Blurred vision
  • Slow-healing sores or frequent infections
  • A1C level greater than 9% or blood glucose levels consistently above target

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient's medical history including previous A1C levels
  • Current medications and adherence
  • Details of symptoms and complications
  • Results of blood glucose monitoring
  • Physical exam findings related to diabetes complications

Coding Guidelines

Usage Guidelines & Examples

  • Usage guidelines: Use E11.65 for uncontrolled diabetes with hyperglycemia.
  • Common errors: Misclassifying controlled diabetes as uncontrolled.

Code Exclusions

Important Exclusions

  • Type 1 Diabetes Mellitus
  • Gestational Diabetes
  • Other specified diabetes mellitus

Related ICD-10 Codes

Primary Codes
E11.65
Type 2 diabetes mellitus with hyperglycemia
E11.9
Type 2 diabetes mellitus without complications
Ancillary Codes
E11.319
E11.22
Z79.4
Differential Codes
E11.9
E11.9
when no complications or control issues are documented.
E11.65
E11.65
when hyperglycemia is documented instead of hypoglycemia.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Endocrinology

Specialty Applications

  • Adult patients with Type 2 Diabetes Mellitus
  • Endocrinology clinics and 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 symptoms, A1C levels, and treatment plan.

What are the billing considerations?

Ensure accurate coding to reflect the severity and complications for appropriate reimbursement.