Wiki E11.628

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Code: E11.628
Type 2 diabetes mellitus with other skin complications
Parent Code Notes: E11
Excludes1: diabetes mellitus due to underlying condition (E08.-)
drug or chemical induced diabetes mellitus (E09.-)
gestational diabetes (O24.4-)
neonatal diabetes mellitus (P70.2)
postpancreatectomy diabetes mellitus (E13.-)
postprocedural diabetes mellitus (E13.-)
secondary diabetes mellitus NEC (E13.-)
type 1 diabetes mellitus (E10.-)
Includes: diabetes (mellitus) due to insulin secretory defect
diabetes NOS
insulin resistant diabetes (mellitus)
Use additional code to identify control using:
insulin (Z79.4)
oral antidiabetic drugs (Z79.84)
oral hypoglycemic drugs (Z79.84)

Category Notes
Diabetes mellitus (E08-E13)

Coding Guidelines
Endocrine, nutritional and metabolic diseases (E00-E89)
Note: All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
Excludes 1: transitory endocrine and metabolic disorders specific to newborn (P70-P74)

Best answers

My doctor is coding DM w Pressure callus and DM with Onychomycosis using E11.628 I couldn't find this combination in the ICD10. Does anyone knows if this can be coded like this?


Marshfield, MO
Best answers
I work in a podiatry clinic and the majority of our patients have DM. I read all the office notes for 3 podiatrists, but I've never seen any of them attribute a callus or nail fungus to diabetes. If it were me, and there are no other complications of diabetes documented, I would code the callus, the fungus and E11.9.
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Best answers
Coding vs. Clniical

As a coder, it is not our position to question the clinical decision making of the provider. It is our job use our years of coding education and training to to code what is documented and let the provider, with their years of clinical education and training, decide which conditions are related and which are not.

The code choice E11.628 is an NEC code that aligns with what you state is documented. To be clear though, since these are not normal diabetic manifestations and are not listed under the "with" choices in the alphabetic index, the provider would need to document the cause-and-effect relationship between diabetes and the onchomycosis/callus with appropriate linking terms (with, associated with, due to, etc.) in order for them to be coded to E11.628. Without the cause-and-effect relationship documented, the should be coded as 3 unrelated conditions.