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ICD-10 Guide
ICD-10 CodesE16.9

E16.9

Billable

Disorder of pancreatic internal secretion, unspecified

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

Code Description

ICD-10 E16.9 is a billable code used to indicate a diagnosis of disorder of pancreatic internal secretion, unspecified.

Key Diagnostic Point:

Disorders of pancreatic internal secretion encompass a range of conditions affecting the pancreas's ability to produce hormones, particularly insulin. This can lead to significant disturbances in glucose metabolism, resulting in either hypoglycemia or hyperglycemia. Hypoglycemia, characterized by abnormally low blood glucose levels, can occur due to excessive insulin production (hyperinsulinism) or inadequate glucose production by the liver. Conversely, hyperinsulinism may lead to recurrent hypoglycemic episodes, particularly in individuals with insulinomas or other pancreatic islet cell tumors. Pancreatic islet disorders can also include conditions such as type 1 and type 2 diabetes mellitus, where insulin secretion is impaired, leading to chronic hyperglycemia. The unspecified nature of this code indicates that the specific disorder affecting pancreatic secretion has not been clearly defined, necessitating further clinical evaluation to determine the underlying cause and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions that can lead to pancreatic secretion disorders.
  • Need for comprehensive clinical documentation to specify the nature of the disorder.
  • Potential overlap with other endocrine disorders, complicating diagnosis.
  • Variability in symptoms and laboratory findings among patients.

Audit Risk Factors

  • Insufficient documentation of the patient's clinical history.
  • Lack of laboratory results supporting the diagnosis.
  • Inconsistent coding of related conditions.
  • Failure to specify the type of pancreatic disorder.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed patient history, including symptoms, lab results, and treatment plans.

Common Clinical Scenarios

Patients presenting with unexplained hypoglycemia or hyperglycemia, requiring evaluation of pancreatic function.

Billing Considerations

Endocrinologists must ensure that all relevant tests are documented to support the diagnosis of pancreatic disorders.

Internal Medicine

Documentation Requirements

Comprehensive assessment of metabolic status and any comorbid conditions.

Common Clinical Scenarios

Management of patients with diabetes or metabolic syndrome who may have underlying pancreatic issues.

Billing Considerations

Internal medicine practitioners should document any referrals to specialists for further evaluation.

Coding Guidelines

Inclusion Criteria

Use E16.9 When
  • According to ICD
  • 10 coding guidelines, E16
  • 9 should be used when the specific disorder of pancreatic internal secretion is not specified
  • Coders must ensure that the documentation supports the use of this unspecified code and consider additional codes for related conditions

Exclusion Criteria

Do NOT use E16.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

83036CPT Code

Glucose test, fasting

Clinical Scenario

Used to evaluate glucose metabolism in patients suspected of having pancreatic disorders.

Documentation Requirements

Document the reason for the test and any relevant clinical findings.

Specialty Considerations

Endocrinologists may require additional tests to confirm diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of pancreatic disorders, enabling better tracking of disease prevalence and management outcomes. E16.9 serves as a catch-all for unspecified disorders, highlighting the need for further investigation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of pancreatic disorders, enabling better tracking of disease prevalence and management outcomes. E16.9 serves as a catch-all for unspecified disorders, highlighting the need for further investigation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of pancreatic disorders, enabling better tracking of disease prevalence and management outcomes. E16.9 serves as a catch-all for unspecified disorders, highlighting the need for further investigation.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should I use E16.9?

E16.9 should be used when there is a disorder of pancreatic internal secretion that has not been specified. Ensure that the documentation supports this diagnosis.