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 CodesE10.42

E10.42

Billable

Type 1 diabetes mellitus with diabetic polyneuropathy

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

Code Description

ICD-10 E10.42 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with diabetic polyneuropathy.

Key Diagnostic Point:

Type 1 diabetes mellitus is a chronic condition characterized by the body's inability to produce insulin due to autoimmune destruction of pancreatic beta cells. Diabetic polyneuropathy is a common complication of diabetes, resulting from prolonged hyperglycemia that leads to nerve damage. Patients with E10.42 experience symptoms such as numbness, tingling, and pain in the extremities, which can significantly impact their quality of life. Management of type 1 diabetes involves regular monitoring of blood glucose levels and maintaining HbA1c levels below 7% to prevent complications. Insulin therapy is essential for these patients, often requiring multiple daily injections or continuous subcutaneous insulin infusion. The presence of diabetic polyneuropathy necessitates a multidisciplinary approach to care, including pain management and physical therapy, to address the neurological symptoms and improve functional outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of diabetes management and complications
  • Need for accurate documentation of neuropathy symptoms
  • Differentiation from other types of diabetes and neuropathies
  • Potential for multiple co-morbidities affecting coding

Audit Risk Factors

  • Inadequate documentation of neuropathy symptoms
  • Failure to document HbA1c levels
  • Misclassification of diabetes type
  • Lack of evidence for insulin management

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed records of blood glucose levels, HbA1c results, and insulin regimen.

Common Clinical Scenarios

Patients presenting with uncontrolled diabetes and neuropathic symptoms.

Billing Considerations

Ensure comprehensive documentation of diabetes management and complications.

Neurology

Documentation Requirements

Neurological assessments, symptom descriptions, and treatment plans for neuropathy.

Common Clinical Scenarios

Patients with diabetic polyneuropathy experiencing pain or sensory loss.

Billing Considerations

Document the extent of neuropathy and its impact on daily activities.

Coding Guidelines

Inclusion Criteria

Use E10.42 When
  • According to ICD
  • 10 coding guidelines, E10
  • 42 should be used when a patient with type 1 diabetes has been diagnosed with diabetic polyneuropathy
  • Documentation must clearly indicate the presence of both conditions, and the severity of neuropathy should be assessed

Exclusion Criteria

Do NOT use E10.42 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for routine follow-up visits for diabetes management.

Documentation Requirements

Document patient's diabetes control, HbA1c levels, and any neuropathy symptoms.

Specialty Considerations

Endocrinologists should ensure comprehensive diabetes management documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of diabetes-related complications, improving the accuracy of patient records and reimbursement processes. E10.42 provides a clear distinction for type 1 diabetes with polyneuropathy, which was less specific in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes-related complications, improving the accuracy of patient records and reimbursement processes. E10.42 provides a clear distinction for type 1 diabetes with polyneuropathy, which was less specific in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. E10.42 provides a clear distinction for type 1 diabetes with polyneuropathy, which was less specific in ICD-9.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What is the significance of coding E10.42?

Coding E10.42 accurately reflects the patient's condition, ensuring appropriate management and reimbursement for the complexities associated with type 1 diabetes and its complications.