Medical Coding Tips – How to Code Pre Diabetes with Hyperglycemia
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Q: How would you code pre-diabetes with hyperglycemia?
A: I’m not going to try to open up Find-A-Code, it will be too slow. If you want to look it up. But we can go to Find-A-Code.
Pre-diabetes is not diabetes, it is not the diabetes code E11. It is not going to be E11, it’s not going to be E10, it’s not going to be E13 or 12. Those are your main endocrine codes, but I can tell you a quick way to look this up. If you know the diabetic codes, you can go into a code like E11.9 and read and it will usually tell you “Hey, heads up. This excludes diabetes” things like that.
You can also look up hyperglycemia and it will usually, the ICD-10 manuals is really good about giving you things to look at and to cross reference, and encoders are even better than the manual because they pop up for you.
Did you have that? Did you find it at all, Schuyler?
Coach Schuyler: I really don’t feel that there’s going to be a combination code because it’s more of the signs and symptoms. It would be more of definitely coding both of them. So you have that pre-diabetes, which is the R73.03. Then, the hypoglycemia is R73.9. Obviously, that’s something that we can more look into, but since it is not a definitive diagnosis, I feel that it would not have that proper combination code like E11.65 does, that diabetes type 2 with hyperglycemia. For the purpose of this, I haven’t found anything that’s what I’ve come into conclusion for in regards to this question.
Coach Alicia: That is a good point to make. That is what separates the people that have experience in coding versus the ones that are newer because you automatically think, Oh, I know. E11 is going to be one of the first codes that you learn because anything you’re going to teach in coding can be done through diabetes, so you’re going to hear it a lot. You’re going to learn I10 for hypertension and E11, so you automatically start thinking of that, but this is actually pre-diabetes and that’s different. Notice that it’s an R code versus an E code which is an endocrine code, it’s how you remember it. It’s an R code which is a completely different area. That should give you a heads-up. It usually confuses everybody so hopefully that’s a good answer for you.
But if you get stumped, that’s the way to do it. Go and look and they’ll say, “Hey, by the way, this excludes pre-diabetes or diabetes due to pancreatectomy or something like that.”
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Berestrand Williams, MD FAAP is a board-certified primary care doctor at Mount Sinai Doctors, seeing patients of all ages Monday – Friday in Greenwich Village. Trained in Connecticut and Massachusetts, he is certified by the American Board of Pediatrics and the American Board of Internal Medicine and a member of the American Academy of Pediatrics and the American College of Physicians. After majoring in Biology and graduating with honors at Harvard University, he was awarded his medical degree from the University of Connecticut’s School of Medicine and completed two residencies – one in Internal Medicine at Boston University’s Boston City Hospital and another in Pediatrics at the combined Boston University School of Medicine – Harvard Pediatric Residency Program. Prior to joining Mount Sinai Doctors, he practiced at the East Boston Neighborhood Health Center for nine years and then served as Chief of Primary Care at Concentra Urgent Care and Family Medicine Center. He has been nationally recognized, receiving the Surgical Scholars Award in 1987 and the AOL Foundation Grant: Franciscan Children’s Hospital in 2001. He has written several publications, including Al. Cardiovascular Collapse Treated with Hemodiaysis, Journal of Critical Care Medicine, January 1991. Dr. Williams is fluent in Spanish.
Mount Sinai Doctors, 52 West 8th Street, is a multispecialty practice with Family Medicine, Gynecology, and Internal Medicine.
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