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ICD-10 Codes For Diabetes

Last modified: Oct 4, 2015.

Coding Diabetes in ICD-10 Can Still Raise Your Blood Sugar...

Diabetes coding is notoriously challenging in ICD-9, and while ICD-10-CM tries to make things a little easier / clearer, the potential for confusion is still present.

There's More Than One Type Of Diabetes...

international symbol for diabetes

I'm pretty sure all of you who made it thus far in this article are familiar with the fact that there are at least two major types of diabetes: type I, or juvenile, and type II, with usual (though not mandatory) adult onset. Just like ICD-9, ICD-10 has different chapters for the different types of diabetes. The table below presents the major types of diabetes, by chapters, in both ICD coding versions.

Diabetes Coding Comparison
ICD-9-CM ICD-10-CM
249._ - Secondary diabetes mellitus E08._ - Diabetes mellitus due to underlying condition
E09._ - Drug or chemical induced diabetes mellitus
E13._ - Other specified diabetes mellitus
250._ - Diabetes mellitus E10._ - Type 1 diabetes mellitus
E11._ - Type 2 diabetes mellitus
648._ - Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium O24._ - Gestational diabetes mellitus in pregnancy
775.1 - Neonatal diabetes mellitus P70.2 - Neonatal diabetes mellitus

This coding structure for diabetes in ICD-10 is very important to understand and remember, as it is virtually always the starting point in assigning codes for all patient encounters seen and treated for diabetes.

How To Code in ICD-10 For Diabetes

1. Determine Diabetes Category

Again, "category" here refers to the four major groups above (not just to type 1 or 2 diabetes):

  • E08 - Diabetes mellitus due to underlying condition
  • E09 - Drug or chemical induced diabetes mellitus
  • E10 - Type 1 diabetes mellitus
  • E11 - Type 2 diabetes mellitus
  • E13 - Other specified diabetes mellitus

Note that, for some reason, E12 has been skipped.

Instructions on Diabetes Categories

Here are some basic instructions on how to code for each of the diabetes categories above:

  • E08 - Diabetes mellitus due to underlying condition. Here, it is important to code the underlying condition FIRST:
    • Congenital rubella (P35.0)
    • Cushing's syndrome (E24.-)
    • Cystic fibrosis (E84.-)
    • Malignant neoplasm (C00-C96)
    • Malnutrition (E40-E46)
    • Pancreatitis and other diseases of the pancreas (K85-K86.-)
  • E09 - Drug or Chemical induced diabetes mellitus . Use a code from T36-T65 chapters to identify the drug or chemical involved in causing diabetes. Also, remember to use code Z79.4 if the patient is using insulin. The examples here are multiple, so I will only list one:
    • T38.3X1A - Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, accidental (unintentional), initial encounter
  • E10 and E11 - These are self-explanatory, except that it is always good practice to use code Z79.4 when the patient is using insulin.
    • T38.3X1A - Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, accidental (unintentional), initial encounter
  • E13 Other specified diabetes mellitus (specified type with). Here, too, you should use the additional code to identify any insulin use (Z79.4). This category includes:
    • diabetes mellitus due to genetic defects of beta-cell function
    • diabetes mellitus due to genetic defects in insulin action
    • postpancreatectomy diabetes mellitus
    • postprocedural diabetes mellitus
    • secondary diabetes mellitus NEC

2. Select 4th ICD-10-CM Diabetes Code Digit

The 4th digit is very impoartant, where applicable, as it allows the coder to specify some of the more common complications of diabetes.

  • 0 = Hyperosmolarity
    • Usually a complication of type 2 diabetes with extremely high blood sugar levels, without the presence of ketones.
    • Example: E08.0 - Diabetes mellitus due to underlying condition with hyperosmolarity
  • 1 = Ketacidosis
    • Dangerous metabolic state caused by high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids, usually associated wit type 1diabetes
    • Example: E08.1 - Diabetes mellitus due to underlying condition with ketoacidosis
  • 2 = Nephropathy
    • Use this in cases where there is documentation for kidney disease caused by diabetes
    • Root ICD-10-CM codeis: E08.2 - Diabetes mellitus due to underlying condition with kidney complications
      • E08.21 - Diabetes mellitus due to underlying condition with diabetic nephropathy
      • E08.22 - Diabetes mellitus due to underlying condition with diabetic chronic kidney disease
      • E08.29 - Diabetes mellitus due to underlying condition with other diabetic kidney complication
  • 3 = Opthalmic
  • 4= Neurological
  • 5 = Circulatory
  • 6 = Other

Final Words

As always, feel free to play with our ICD-10 code search tool - you should be able to pull the ICD-10 codes of any heart failure diagnosis by entering the corresponding keywords.