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ICD-10 Guide
ICD-10 CodesE11.40

E11.40

Billable

Type 2 diabetes mellitus with diabetic neuropathy, unspecified

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

Code Description

ICD-10 E11.40 is a billable code used to indicate a diagnosis of type 2 diabetes mellitus with diabetic neuropathy, unspecified.

Key Diagnostic Point:

E11.40 refers to Type 2 diabetes mellitus characterized by the presence of diabetic neuropathy, a common complication that affects the peripheral nervous system. Patients with this condition may experience symptoms such as numbness, tingling, pain, or weakness in the extremities. The neuropathy can result from prolonged hyperglycemia, leading to nerve damage due to metabolic and vascular changes. The unspecified nature of this code indicates that the specific type or location of neuropathy is not documented, which can complicate management and treatment. Effective management of Type 2 diabetes involves controlling blood glucose levels, typically monitored through HbA1c levels, which should ideally be maintained below 7% to minimize complications. Insulin therapy may be required for some patients, especially if oral medications are insufficient. Regular monitoring for diabetic complications, including neuropathy, is essential for preventing further morbidity.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of neuropathy symptoms
  • Need for precise HbA1c level reporting
  • Differentiation from other types of diabetes complications
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed records of diabetes management, including medication regimens and HbA1c levels.

Common Clinical Scenarios

Patients presenting with uncontrolled diabetes and neuropathic symptoms.

Billing Considerations

Ensure comprehensive documentation of all diabetes-related complications.

Neurology

Documentation Requirements

Thorough neurological assessments and symptom descriptions.

Common Clinical Scenarios

Patients with neuropathic pain or sensory loss due to diabetes.

Billing Considerations

Document specific neurological findings to support coding.

Coding Guidelines

Inclusion Criteria

Use E11.40 When
  • According to ICD
  • 10 guidelines, E11
  • 40 should be used when a patient has Type 2 diabetes with diabetic neuropathy that is not specified
  • Coders must ensure that the documentation supports the diagnosis and that other potential complications are ruled out

Exclusion Criteria

Do NOT use E11.40 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 of diabetes management.

Documentation Requirements

Document patient history, examination findings, and management plan.

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 facilitating better management of diabetes and its complications.

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 facilitating better management of diabetes and its complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes and its complications.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What is the significance of the unspecified designation in E11.40?

The unspecified designation indicates that the specific type or location of diabetic neuropathy has not been documented, which can affect treatment and management decisions.