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Diabetes in the United States
 9.3% of the population suffer from diabetes.
 27.8 % have undiagnosed diabetes
 26 % of the senior population have diabetes
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Diabetes is the leading cause of kidney
failure accounting for 44% of all new cases of
kidney failure. Annually, 49,677 Americans
begin treatment for kidney failure due to
diabetes. A total of 228,924 people with
kidney failure due to diabetes are living on
chronic dialysis or with a kidney transplant in
the United States
About 60% to 70% of people with diabetes
have mild to severe forms of neuropathy.
More than 60% of non-traumatic lower-limb
amputations occur in people with diabetes.
About 73,000 non-traumatic lower-limb
amputations are performed in people with
diabetes annually.
Information from American Diabetes Association
http://professional.diabetes.org
Screening Diabetes
 Hypertension-BP should be taken at every
visit
 Blood glucose control-HbA1c. Every 3
months until target level is reached;
thereafter monitored every 12 months
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Foot ulcers-Physical exam focused on ankle
reflexes, dorsalis pedis pulse, and vibratory
sensation and monofilament touch sensation
performed by provider. Should be done
every 3 months for high risk patients.
Increased risk patients screened annually
Microalbuminuria- Lab done annually
Hyperlipidemia-Fasting LDL annually
Retinopathy-Dilated eye exam by an eye
service professional. Patients with evidence
of retinopathy should have annual screening.
Patients without evidence should be
screened every 2-3 years
Electrolyte and chemistry abnormalitiesSerum creatinine and serum potassium test
annually
https://www.ghc.org/allsites/guidelines/diabetes2.pdf
Documenting Diabetes
The terms “uncontrolled” and “not stated as
“uncontrolled” are no longer used in ICD‐10‐
CM. Instead the codes descriptors indicate “with
complications” or without complications
The diabetes mellitus codes have expanded in
ICD‐10‐CM. From 59 codes in ICD-9 to close
200 codes in ICD-10.
Diabetes documentation must include:
• Type of diabetes
• Body system affected
• Complication or manifestation
• If a patient with type 2 diabetes is using insulin,
a secondary code for long term insulin use is
required. (ICD-10 code Z79.4)
Categories in Diabetes
There are five categories for diabetes codes in
ICD‐10‐CM:
 E08 Diabetes mellitus due to an underlying
condition
 E09 Drug or chemical induced diabetes
mellitus
 E10 Type 1 diabetes mellitus
 E11 Type 2 diabetes mellitus
 E13 Other specified diabetes mellitus
ICD-10 Coding Diabetes Mellitus
The 5th character and 6th character provides further
specificity regarding the complication
E10.2- Type 1 diabetes mellitus kidney complications
E11.2- Type 2 diabetes mellitus kidney complications
E10.3- Type 1 diabetes mellitus ophthalmic
complications
E11.3- Type 2 diabetes mellitus ophthalmic
complications
E10.4- Type 1 diabetes mellitus neurological
complications
E11.4- Type 2 diabetes mellitus neurological
complications
E10.5- Type 1 diabetes mellitus circulatory
complications
E11.5- Type 2 diabetes mellitus circulatory
complications
E10.6- Type 1 diabetes mellitus other specified
complications
E11.6- Type 2 diabetes mellitus other specified
complications
E10.8- Type 1 diabetes mellitus unspecified
complications
E11.8- Type 2 diabetes mellitus unspecified
complications
E10.9- Type 1 diabetes mellitus complications
E11.9- Type 2 diabetes mellitus complications
Note: Use additional code to identify any insulin use
(Z79.4).