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Diabetes, type 2, uncontrolled for I-10

  1. #1
    Default Diabetes, type 2, uncontrolled for I-10
    Medical Coding Books
    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.

    Does anyone have any information that could help clarify this? Anything would be appreciated!

    Thanks!!!
    Last edited by asmith79; 11-06-2014 at 01:15 PM.

  2. #2
    Default
    The ICD-10-CM page 95 states "Diabetes inadequately controlled using hyperglycemia" see by type. Therefore, if the patient is type II you would code E11.65 which is the inadequately controlled portion, type II.

    Hope this helps
    Amy Pritchett,
    BSHA, CPC, CPMA, CPC-I, CDEO, CANPC, CEDC, CASCC, CRC, CMDP, CMPM, CCS, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

  3. #3
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    Thank you amy, that is my thought as well. However, the argument i am hearing is that if the note just states "uncontrolled", how are we to determine if it is hypo or hyper? The e11.65 specifically states hyper. There is also arguments that "uncontrolled" and "out of control" do not mean the same thing.

  4. #4
    Default
    You know, ICD-10-CM is so difficult to wrap your head around due to the codes being more defined and sometimes more complicated.
    There is no such ICD-10-CM code (that I have seen) that would relate to hypoglycemia. That would simply be the type of diabetes mellitus with the additional code of hypoglycemia. You would use the E11.65 if states hyperglycemia (which in ICD-9-CM and ICD-10) mean uncontrolled.

    I am unsure of where the conflict is coming into play here Let me know if this helps you!!!
    Amy Pritchett,
    BSHA, CPC, CPMA, CPC-I, CDEO, CANPC, CEDC, CASCC, CRC, CMDP, CMPM, CCS, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

  5. #5
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    I don't suppose you have any information or could point me in the direction of where I could find something stating that in I-9 and I-10 hyperglycemia mean uncontrolled?


    Angela Smith, CPC, CFPC, COBGC

  6. #6
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    Quote Originally Posted by Amy Pritchett View Post
    The ICD-10-CM page 95 states "Diabetes inadequately controlled using hyperglycemia" see by type. Therefore, if the patient is type II you would code E11.65 which is the inadequately controlled portion, type II.

    Hope this helps
    No where in the ICD-10 CM guidelines do I find the statement you are referencing, nor do I find a reference in the alpha under diabetes or uncontrolled that will lead to this conclusion, I have looked through the book carefully and do not find this statement. None of the diagnosis codes stated controlled or uncontrolled, and no where do I see that diabetes with hyperglycemia is the same as uncontrolled. You stated it was on page 95, but I am not seeing what you have stated in the ICD-10 CM book that I have. Since uncontrolled is not a complication of the diabetes then it would it not be E11.9 for type 2? If you have information that states different I would love to be able to see this.
    E11.64- is type II with hypoglycemia

    Debra A. Mitchell, MSPH, CPC-H

  7. Default Follow up 2016 , 2017
    Hi everyone - has this statement changed in 2016 and going forward in 2017 .... when Uncontrolled, or out of control Diabetes is written it is still considered E11.65 Diabetes with hyperglycemia ? I have encountered confusion with collegues on this subject too.
    Last edited by syoung57; 09-30-2016 at 01:45 PM. Reason: code was not complete

  8. Default
    Quote Originally Posted by syoung57 View Post
    Hi everyone - has this statement changed in 2016 and going forward in 2017 .... when Uncontrolled, or out of control Diabetes is written it is still considered E11.65 Diabetes with hyperglycemia ? I have encountered confusion with collegues on this subject too.
    Yes! If it is documented as "poorly controlled", "out of control" or "uncontrolled" then you would assign the code for the diabetes by type with hyperglycemia!

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