ICD-10 Coding for Diabetes Mellitus with Microalbuminuria(E11.21, E11.29)
Complete ICD-10-CM coding and documentation guide for Diabetes Mellitus with Microalbuminuria. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetes Mellitus with Microalbuminuria
E10-E14Primary Range
Diabetes mellitus
This range includes all types of diabetes mellitus and their complications, including kidney-related issues such as microalbuminuria.
Abnormal findings on examination of urine, without diagnosis
This range includes codes for proteinuria, which may be used as secondary codes to indicate the presence of microalbuminuria.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.21 | Type 2 diabetes mellitus with diabetic nephropathy | Use when microalbuminuria is explicitly linked to diabetic nephropathy. |
|
| E11.29 | Type 2 diabetes mellitus with other diabetic kidney complication | Use when microalbuminuria is present without nephropathy specification. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for diabetes with microalbuminuria
Essential facts and insights about Diabetes Mellitus with Microalbuminuria
Primary ICD-10-CM Codes for diabetes mellitus with microalbuminuria
Decision Criteria
clinical Criteria
- Presence of microalbuminuria with nephropathy indicators
Applicable To
- Diabetic nephropathy with microalbuminuria
Excludes
- Type 1 diabetes mellitus with nephropathy (E10.21)
Clinical Validation Requirements
- Documented microalbumin:creatinine ratio (MACR) ≥30 mg/g
- Presence of diabetic retinopathy or long-standing diabetes
Code-Specific Risks
- Incorrectly coding without nephropathy documentation
Coding Notes
- Ensure documentation specifies nephropathy if using E11.21.
E11.29 - Type 2 diabetes mellitus with other diabetic kidney complication
Use when microalbuminuria is present without nephropathy specification.
Applicable To
- Diabetes with early kidney disease
Excludes
- Diabetic nephropathy (E11.21)
Clinical Validation Requirements
- Documented MACR 30-300 mg/g without nephropathy
Coding Notes
Ensure microalbuminuria is documented without nephropathy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Persistent proteinuria, unspecified
R80.1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetes Mellitus with Microalbuminuria to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.21.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure lab results are included in documentation., Verify documentation before coding.
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use E11.29 for diabetes with microalbuminuria.
Impact
Risk of incorrect coding without proper documentation.
Mitigation Strategy
Regular audits and provider education.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Diabetes Mellitus with Microalbuminuria, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetes Mellitus with Microalbuminuria
Use these documentation templates to ensure complete and accurate documentation for Diabetes Mellitus with Microalbuminuria. These templates include all required elements for proper coding and billing.
Type 2 diabetes with confirmed microalbuminuria
Specialty: EndocrinologyRequired Elements
- Patient history
- Lab results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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