ICD-10-CM Billable Code

E11.65

Type 2 diabetes mellitus with hyperglycemia

Clinical Classification Guidelines

Medical Intelligence & Overview

Type 2 diabetes mellitus with hyperglycemia, classified under ICD-10 code E11.65, is a form of diabetes characterized by high blood sugar levels due to insulin resistance and impaired insulin secretion. This condition is common among adults and can lead to severe health complications if not managed properly. It involves elevated blood glucose levels that persist over time, often requiring ongoing medical attention to control and prevent further health issues.

Causes & Symptoms

Clinical Causes: Genetic factors that increase susceptibility to insulin resistance Obesity, especially excess abdominal fat Unhealthy diet high in refined sugars and saturated fats Sedentary lifestyle with little physical activity Aging, which can affect insulin sensitivity Certain medical conditions such as hypertension and high cholesterol Family history of diabetes

Key Symptoms: Frequent urination Excessive thirst Increased hunger Unexplained weight loss Fatigue and weakness Blurred vision Slow-healing sores or infections Areas of darkened skin, typically around the neck or armpits

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves blood tests such as fasting blood glucose, oral glucose tolerance test (OGTT), and hemoglobin A1c (HbA1c). An HbA1c level of 6.5% or higher, fasting blood glucose of 126 mg/dL or higher, or a 2-hour plasma glucose of 200 mg/dL or higher during an OGTT can confirm the presence of diabetes. Healthcare professionals use these markers to assess blood sugar control over time. Additional tests may be conducted to evaluate for diabetes-related complications.

Treatment Protocols: Managing type 2 diabetes with hyperglycemia involves a combination of lifestyle changes and medication. Strategies include: - Adopting a balanced diet rich in fiber, vegetables, lean proteins, and healthy fats - Engaging in regular physical activity like walking, swimming, or cycling - Monitoring blood glucose levels regularly - Maintaining a healthy weight - Taking prescribed medications such as oral hypoglycemic agents or insulin therapy as directed by a healthcare provider - Managing associated conditions like high blood pressure and cholesterol - Regular check-ups to monitor for potential complications In some cases, structured diabetes education and support programs can assist individuals in managing their condition effectively.

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 E11.65 a billable ICD-10 code?
Yes, E11.65 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report E11.65?
Clinical documentation must specify the nature of Type 2 diabetes mellitus with hyperglycemia and any associated comorbidities for accurate reporting.

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