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Icd 10 Code For Diabetes Mellitus Type 2 Uncontrolled

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  1. asmith79

    I am looking for any information on coding Diabetes, Type 2, uncontrolled for ICD 10. In a recent educational discussion there was some confusion on which was the appropriate code to use, E11.9 or E11.65. The thought behind E11.65 is that the terms "uncontrolled" and "out of control" have the same meaning. When you look in the alpha index under diabetes, out of control, ( page 95) , it directs you to code "Diabetes, specificed type, with hyperglycemia" which would take you to E11.65.
    During the discussion some argued that the terms "uncontrolled" and "inadequately controlled" or "out of control" did not have the same meaning. Does any one have any documentation supporting or disputing this?
    Also, it was brought up that since our chart just said "uncontrolled" how could we use the code E11.65 since it specifically stated hyperglycemia? Is there any documentation out there stating that "uncontrolled" diabetes refers to hyperglycemia?
    Anything would be appreciated!
    Thanks!!!
    Angela Smith CPC, CFPC, COBGC

  2. BenCrocker

    Found this: http://journal.ahima.org/2012/05/16/...n-icd-10-cm-4/ Apparently ICD 10 doesn't use the term UNCRONTROLLED anymore. It's either inadequately controlled, Out of control, or Poorly controlled.

  3. mitchellde

    Originally Posted by BenCrocker
    Found this: http://journal.ahima.org/2012/05/16/...n-icd-10-cm-4/ Apparently ICD 10 doesn't use the term UNCRONTROLLED anymore. It's either inadequately controlled, Out of control, or Poorly controlled. The problem I have with articles like this is that this is someone's version or opinion and they wrote an article. At no time is an official source cited for that statement. I agree that diabetes with hyperglycemia is an out of control disease process, however I do not agree that just because the provider documents "uncontrolled", that this is always what they are referencing. In other words a diabetic patient that does not always adhere to proper diet or does not take the insulin correctly, while they may not yet be hyperglycemic, the provider may document the diabetes is poorly controlled. The coding guidelines do not direct us to code uncontrolled status as diabetes with hyperglycemia. And the classification does not have a listing for diabetes, uncontrolled, or uncontrolled, diabetes. Without an official source, I will default to , if the provider does not state diabetes with hyperglycemia, then it cannot be coded that way.
    Another point to consider on this, an endocrinologist once told me that the reason the ICD-9 classification choices state, uncontrolled, or not stated as uncontrolled instead of uncontrolled vs controlled, is that diabetes is truly never in a "controlled" state and the reason this is not stated this way in ICD-10 CM is because the physician does not need to document this, it is understood that the reason we monitor the diabetic patient as closely as we do is because they are never truly under control. He had a lot more to say on this subject and it does make sense.
    So I would hesitate to put stock in an article that makes a bold statement but does not back it up.

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Diabetes Mellitus Icd-10 Case Study | Practice Fusion

A 40-year-old male presents in his physicians office with complaints of new onset of excessive thirst, urinary frequency and fatigue. His physician ran several tests and based on the results he diagnosed his patient with Type 2 diabetes mellitus. The value of describing patient conditions with ICD-10 codes as compared to ICD-9 codes is made evident when comparing codes available for specific conditions. A common disease affecting millions of patients is diabetes mellitus. According to the American Diabetes Association, Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels. In spite of the significant prevalence of this disease, ICD-9 codes describing this condition lack specificity, resulting in the lumping of many patients into broad categories that are not as useful for comparisons and quality measures as ICD-10 codes will be once implemented. Patients with diabetes mellitus are most often described with Continue reading >>

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  1. asmith79

    I am looking for any information on coding Diabetes, Type 2, uncontrolled for ICD 10. In a recent educational discussion there was some confusion on which was the appropriate code to use, E11.9 or E11.65. The thought behind E11.65 is that the terms "uncontrolled" and "out of control" have the same meaning. When you look in the alpha index under diabetes, out of control, ( page 95) , it directs you to code "Diabetes, specificed type, with hyperglycemia" which would take you to E11.65.
    During the discussion some argued that the terms "uncontrolled" and "inadequately controlled" or "out of control" did not have the same meaning. Does any one have any documentation supporting or disputing this?
    Also, it was brought up that since our chart just said "uncontrolled" how could we use the code E11.65 since it specifically stated hyperglycemia? Is there any documentation out there stating that "uncontrolled" diabetes refers to hyperglycemia?
    Anything would be appreciated!
    Thanks!!!
    Angela Smith CPC, CFPC, COBGC

  2. BenCrocker

    Found this: http://journal.ahima.org/2012/05/16/...n-icd-10-cm-4/ Apparently ICD 10 doesn't use the term UNCRONTROLLED anymore. It's either inadequately controlled, Out of control, or Poorly controlled.

  3. mitchellde

    Originally Posted by BenCrocker
    Found this: http://journal.ahima.org/2012/05/16/...n-icd-10-cm-4/ Apparently ICD 10 doesn't use the term UNCRONTROLLED anymore. It's either inadequately controlled, Out of control, or Poorly controlled. The problem I have with articles like this is that this is someone's version or opinion and they wrote an article. At no time is an official source cited for that statement. I agree that diabetes with hyperglycemia is an out of control disease process, however I do not agree that just because the provider documents "uncontrolled", that this is always what they are referencing. In other words a diabetic patient that does not always adhere to proper diet or does not take the insulin correctly, while they may not yet be hyperglycemic, the provider may document the diabetes is poorly controlled. The coding guidelines do not direct us to code uncontrolled status as diabetes with hyperglycemia. And the classification does not have a listing for diabetes, uncontrolled, or uncontrolled, diabetes. Without an official source, I will default to , if the provider does not state diabetes with hyperglycemia, then it cannot be coded that way.
    Another point to consider on this, an endocrinologist once told me that the reason the ICD-9 classification choices state, uncontrolled, or not stated as uncontrolled instead of uncontrolled vs controlled, is that diabetes is truly never in a "controlled" state and the reason this is not stated this way in ICD-10 CM is because the physician does not need to document this, it is understood that the reason we monitor the diabetic patient as closely as we do is because they are never truly under control. He had a lot more to say on this subject and it does make sense.
    So I would hesitate to put stock in an article that makes a bold statement but does not back it up.

  4. -> Continue reading
read more
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Type I and Type II Diabetes, Controlled or Uncontrolled in ICD-9 (Coding Tip by PPS Plus) Click here for more coding tips by PPS Plus: https://www.youtube.com/watch?v=pOfOX... Conquer your coding & OASIS challenges with the best home health tips on YouTube. Do you have a tough coding scenario? Tell us about it in the comment box below, and you might just see your scenario in one of our upcoming YouTube videos! PPS Plus provides the perfect solution for maximizing your reimbursement potential, growing your business and providing your patients with better care. We provide OASIS analysis software, benchmarking software, coding & OASIS review services, as well as online and on-site education and consulting services. ************************************ Dont compromise your OASIS. Lets analyze it! http://bit.ly/OASISAnalysisPlus ************************************ Sign up to receive our FREE monthly Newswire: http://bit.ly/PPSPlusNewswire Lets Connect & Chat it Up! ************************** Website: http://ppsplus.com/ Facebook: https://www.facebook.com/ppsplus Twitter: https://twitter.com/ppsplus Google +: https://plus.google.com/+Ppsplus/posts LinkedIn: https://www.linkedin.com/comp

Coding Tip: Uncontrolled Diabetes Mellitus In Icd-10

Coding Tip: Uncontrolled Diabetes Mellitus in ICD-10 How do coders report uncontrolled DM in ICD-10-CM? First, coders will need to have further documentation of hyperglycemia or hypoglycemia as there is no default code for uncontrolled diabetes. Uncontrolled diabetes is classified by type and whether it is hyperglycemia or hypoglycemia. The term uncontrolled is not synonymous with hyperglycemia. The term poorly controlled is synonymous with hyperglycemia when referring to diabetes in ICD-10-CM. In ICD-9-CM, uncontrolled diabetes had a specific 5th digit to show that the diabetes was controlled or uncontrolled. This is no longer the case in ICD-10-CM. If the patient has documented uncontrolled diabetes, without further clarification of hyperglycemia and/or hypoglycemia, a query is necessary to clarify which type the patient has. If the patient does have documented hyperglycemia or hypoglycemia in addition to the diagnosis of uncontrolled diabetes, ICD-10-CM codes would be used to show that the diabetes is with hyperglycemia and/or hypoglycemia. Is uncontrolled and poorly controlled DM the same? No, uncontrolled and poorly controlled are not interchangeable when describing diabetes Continue reading >>

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Popular Questions

  1. asmith79

    I am looking for any information on coding Diabetes, Type 2, uncontrolled for ICD 10. In a recent educational discussion there was some confusion on which was the appropriate code to use, E11.9 or E11.65. The thought behind E11.65 is that the terms "uncontrolled" and "out of control" have the same meaning. When you look in the alpha index under diabetes, out of control, ( page 95) , it directs you to code "Diabetes, specificed type, with hyperglycemia" which would take you to E11.65.
    During the discussion some argued that the terms "uncontrolled" and "inadequately controlled" or "out of control" did not have the same meaning. Does any one have any documentation supporting or disputing this?
    Also, it was brought up that since our chart just said "uncontrolled" how could we use the code E11.65 since it specifically stated hyperglycemia? Is there any documentation out there stating that "uncontrolled" diabetes refers to hyperglycemia?
    Anything would be appreciated!
    Thanks!!!
    Angela Smith CPC, CFPC, COBGC

  2. BenCrocker

    Found this: http://journal.ahima.org/2012/05/16/...n-icd-10-cm-4/ Apparently ICD 10 doesn't use the term UNCRONTROLLED anymore. It's either inadequately controlled, Out of control, or Poorly controlled.

  3. mitchellde

    Originally Posted by BenCrocker
    Found this: http://journal.ahima.org/2012/05/16/...n-icd-10-cm-4/ Apparently ICD 10 doesn't use the term UNCRONTROLLED anymore. It's either inadequately controlled, Out of control, or Poorly controlled. The problem I have with articles like this is that this is someone's version or opinion and they wrote an article. At no time is an official source cited for that statement. I agree that diabetes with hyperglycemia is an out of control disease process, however I do not agree that just because the provider documents "uncontrolled", that this is always what they are referencing. In other words a diabetic patient that does not always adhere to proper diet or does not take the insulin correctly, while they may not yet be hyperglycemic, the provider may document the diabetes is poorly controlled. The coding guidelines do not direct us to code uncontrolled status as diabetes with hyperglycemia. And the classification does not have a listing for diabetes, uncontrolled, or uncontrolled, diabetes. Without an official source, I will default to , if the provider does not state diabetes with hyperglycemia, then it cannot be coded that way.
    Another point to consider on this, an endocrinologist once told me that the reason the ICD-9 classification choices state, uncontrolled, or not stated as uncontrolled instead of uncontrolled vs controlled, is that diabetes is truly never in a "controlled" state and the reason this is not stated this way in ICD-10 CM is because the physician does not need to document this, it is understood that the reason we monitor the diabetic patient as closely as we do is because they are never truly under control. He had a lot more to say on this subject and it does make sense.
    So I would hesitate to put stock in an article that makes a bold statement but does not back it up.

  4. -> Continue reading
read more

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