ICD-10-CM Billable Code

E13.11

Other specified diabetes mellitus with ketoacidosis with coma

Clinical Classification Guidelines

Medical Intelligence & Overview

ICD-10 Code E13.11 refers to a specific form of diabetes mellitus characterized by the presence of ketoacidosis accompanied by a coma. Diabetes mellitus is a chronic condition that affects how your body processes blood sugar (glucose). The type indicated by E13.11 falls under 'Other specified diabetes mellitus,' meaning it doesn't fit into the common categories like Type 1 or Type 2 but still causes significant health issues. This condition is a serious complication that requires prompt medical attention to prevent severe health consequences.

Causes & Symptoms

Clinical Causes: Insufficient insulin production by the pancreas Severe illness or infection that increases blood sugar levels Missed or inadequate diabetes management or medication Certain medications that impact blood sugar control High intake of carbohydrates or sugary foods Physical or emotional stress affecting insulin effectiveness Alcohol abuse or substance misuse

Key Symptoms: Rapid breathing or shortness of breath Excessive urination and increased thirst Persistent nausea and vomiting Abdominal pain Confusion or difficulty concentrating Unconsciousness or coma in severe cases Weakness or fatigue Fruity-smelling breath Dry skin and mucous membranes Elevated blood glucose levels

Diagnostic & Treatment

Diagnosis Path: Diagnosing this condition involves a combination of medical history, physical examination, and laboratory tests. Key diagnostic steps include measuring blood glucose levels, blood ketone levels, and arterial blood gases to assess the presence and severity of ketoacidosis. Additional tests may include urine tests for ketones and glucose. A healthcare provider will evaluate symptoms alongside laboratory results to confirm the diagnosis of E13.11.

Treatment Protocols: Treating this condition requires immediate medical intervention typically provided in a hospital setting. The primary goals are to normalize blood glucose and ketone levels, treat the underlying cause, and support vital functions. Common treatment approaches include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is E13.11 a billable ICD-10 code?
Yes, E13.11 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report E13.11?
Clinical documentation must specify the nature of Other specified diabetes mellitus with ketoacidosis with coma and any associated comorbidities for accurate reporting.

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