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ICD-10 Guide
ICD-10 CodesE11.649

E11.649

Billable

Type 2 diabetes mellitus with hypoglycemia without coma

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

Code Description

ICD-10 E11.649 is a billable code used to indicate a diagnosis of type 2 diabetes mellitus with hypoglycemia without coma.

Key Diagnostic Point:

E11.649 refers to Type 2 diabetes mellitus characterized by episodes of hypoglycemia that do not result in a coma. This condition is prevalent among individuals with Type 2 diabetes, particularly those who are on insulin therapy or certain oral hypoglycemic agents. Hypoglycemia occurs when blood glucose levels drop below normal, leading to symptoms such as sweating, trembling, confusion, and palpitations. It is crucial for patients to monitor their blood glucose levels regularly and manage their diet and medication to prevent hypoglycemic episodes. The management of Type 2 diabetes often involves lifestyle modifications, oral medications, and sometimes insulin therapy. The HbA1c levels, which reflect average blood glucose over the past 2-3 months, should ideally be maintained below 7% to reduce the risk of complications. However, aggressive management can lead to hypoglycemia, especially in older adults or those with renal impairment. Understanding the balance between glycemic control and the risk of hypoglycemia is essential for effective diabetes management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between hypoglycemia with and without coma
  • Understanding the nuances of diabetes management and medication adjustments
  • Interpreting HbA1c levels in relation to hypoglycemic episodes
  • Recognizing the impact of co-morbid conditions on diabetes management

Audit Risk Factors

  • Inadequate documentation of hypoglycemic episodes
  • Failure to document medication adjustments
  • Lack of clear HbA1c level reporting
  • Not specifying the type of diabetes management (insulin vs. oral agents)

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed records of blood glucose monitoring, medication regimens, and HbA1c levels.

Common Clinical Scenarios

Patients presenting with recurrent hypoglycemia, medication adjustments, and complications related to diabetes.

Billing Considerations

Endocrinologists must ensure that all aspects of diabetes management are documented, including lifestyle changes and patient education.

Primary Care

Documentation Requirements

Comprehensive patient history, medication lists, and monitoring logs.

Common Clinical Scenarios

Routine follow-ups for diabetes management, addressing hypoglycemic symptoms, and lifestyle counseling.

Billing Considerations

Primary care providers should focus on patient education regarding hypoglycemia and its prevention.

Coding Guidelines

Inclusion Criteria

Use E11.649 When
  • According to ICD
  • 10 guidelines, E11
  • 649 should be used when a patient with Type 2 diabetes experiences hypoglycemia without coma
  • It is essential to document the frequency and severity of hypoglycemic episodes and any related treatment adjustments

Exclusion Criteria

Do NOT use E11.649 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for diabetes management.

Documentation Requirements

Document patient's diabetes status, treatment plan, and any hypoglycemic episodes.

Specialty Considerations

Endocrinologists may require more detailed documentation compared to primary care.

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 conditions, improving the accuracy of diabetes management documentation and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes-related conditions, improving the accuracy of diabetes management documentation and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What is the significance of E11.649 in diabetes management?

E11.649 is crucial for accurately documenting cases of Type 2 diabetes with hypoglycemia, ensuring appropriate treatment and reimbursement.