E11.21
Type 2 diabetes mellitus with diabetic nephropathy
Clinical Classification Guidelines
Inclusion Terms
- Type 2 diabetes mellitus with intercapillary glomerulosclerosis
- Type 2 diabetes mellitus with intracapillary glomerulonephrosis
- Type 2 diabetes mellitus with Kimmelstiel-Wilson disease
Medical Intelligence & Overview
Type 2 diabetes mellitus with diabetic nephropathy is a complication of diabetes that affects the kidneys. It occurs when high blood sugar levels damage the small blood vessels in the kidneys, impairing their ability to filter waste effectively. This condition is also referred to by various medical terms, including Kimmelstiel-Wilson disease, intercapillary glomerulosclerosis, and intracapillary glomerulonephrosis. Recognizing and managing this condition early can help prevent kidney failure and improve quality of life.
Causes & Symptoms
Clinical Causes: Prolonged high blood sugar levels from poorly controlled diabetes High blood pressure that can damage kidney blood vessels Genetic factors influencing susceptibility to kidney damage Presence of other health problems such as high cholesterol or obesity Family history of kidney disease or diabetes-related complications
Key Symptoms: Swelling in the feet, ankles, or legs (edema) Dark-colored urine or urine with foam Fatigue and weakness Loss of appetite and nausea Elevated blood pressure Weight loss or gain without clear reason Frequent urination, especially at night Signs of worsening kidney function such as decreased urine output
Diagnostic & Treatment
Diagnosis Path: Blood tests to assess kidney function such as serum creatinine and estimated glomerular filtration rate (eGFR) Urinalysis to detect protein (albumin) and abnormal cells in the urine Blood tests for blood sugar levels and HbA1c to evaluate diabetes control Imaging studies like ultrasound to assess kidney size and structure Sometimes, a kidney biopsy may be performed to confirm the diagnosis and assess the extent of damage
Treatment Protocols: Maintaining optimal blood glucose levels with diet, exercise, and prescribed medications Using antihypertensive drugs such as ACE inhibitors or angiotensin II receptor blockers to lower blood pressure and reduce kidney damage Monitoring kidney function regularly through tests Limiting salt intake to help control blood pressure and swelling Managing cholesterol levels through diet and medication Avoiding nephrotoxic drugs and substances that can harm the kidneys In advanced cases, preparing for dialysis or kidney transplantation might be necessary
Clinical Advice & FAQs
Billing Guidance
Is E11.21 a billable ICD-10 code?
Yes, E11.21 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report E11.21?
Clinical documentation must specify the nature of Type 2 diabetes mellitus with diabetic nephropathy and any associated comorbidities for accurate reporting.
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