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ICD-10 Coding for Diabetes with Ketoacidosis(E11.10, E11.11)

Complete ICD-10-CM coding and documentation guide for Diabetes with Ketoacidosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

DKADiabetic Ketoacidosis

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Related ICD-10 Code Ranges

Complete code families applicable to Diabetes with Ketoacidosis

E10-E14Primary Range

Diabetes mellitus

This range includes all types of diabetes mellitus, including those with complications such as ketoacidosis.

O24

Diabetes mellitus in pregnancy, childbirth, and the puerperium

This range is relevant for cases of gestational diabetes with ketoacidosis.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
E11.10Type 2 diabetes mellitus with ketoacidosis without comaUse when documenting Type 2 diabetes with ketoacidosis without coma.
  • Arterial pH <7.30
  • Serum bicarbonate <18 mEq/L
  • Anion gap >12
  • + 1 more
E11.11Type 2 diabetes mellitus with ketoacidosis with comaUse when documenting Type 2 diabetes with ketoacidosis with coma.
  • Arterial pH <7.30
  • Serum bicarbonate <18 mEq/L
  • Anion gap >12
  • + 1 more

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 ketoacidosis

Essential facts and insights about Diabetes with Ketoacidosis

The ICD-10 code for Type 2 diabetes with ketoacidosis without coma is E11.10, and with coma is E11.11.

Primary ICD-10-CM Codes for diabetes with ketoacidosis

E11.10
Type 2 diabetes mellitus with ketoacidosis without coma
Billable Code

Decision Criteria

clinical Criteria

  • Presence of ketoacidosis symptoms and lab confirmation

documentation Criteria

  • Explicit mention of Type 2 diabetes with ketoacidosis

Applicable To

  • Type 2 diabetes with ketoacidosis

Excludes

  • Type 1 diabetes mellitus with ketoacidosis (E10.10)

Clinical Validation Requirements

  • Arterial pH <7.30
  • Serum bicarbonate <18 mEq/L
  • Anion gap >12
  • Serum ketones ≥3.0 mmol/L

Code-Specific Risks

  • Ensure accurate documentation of diabetes type to avoid miscoding.

Coding Notes

  • Ensure the type of diabetes is clearly documented to select the correct code.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Long term (current) use of insulin

Z79.4
Use when the patient is on insulin therapy.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Type 1 diabetes mellitus with ketoacidosis without coma

E10.10
Use for Type 1 diabetes cases, confirmed by patient history or clinical documentation.

Type 1 diabetes mellitus with ketoacidosis with coma

E10.11
Use for Type 1 diabetes cases with coma, confirmed by patient history or clinical documentation.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Diabetes with Ketoacidosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.10.

Impact

Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.

Mitigation Strategy

Always specify the type of diabetes in clinical notes., Use templates that prompt for diabetes type.

Impact

Reimbursement: Incorrect coding can lead to lower reimbursement., Compliance: Non-compliance with updated coding guidelines., Data Quality: Inaccurate data reporting and analysis.

Mitigation Strategy

Use E11.10 or E11.11 for Type 2 diabetes with ketoacidosis.

Impact

Failure to document the type of diabetes can lead to coding errors.

Mitigation Strategy

Implement mandatory fields in EHR for diabetes type.

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 with Ketoacidosis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Diabetes with Ketoacidosis

Use these documentation templates to ensure complete and accurate documentation for Diabetes with Ketoacidosis. These templates include all required elements for proper coding and billing.

Emergency Department Note for DKA

Specialty: Emergency Medicine

Required Elements

  • Type of diabetes
  • Presence of ketoacidosis
  • Coma status
  • Precipitating factors
  • Lab results

Example Documentation

Assessment: Type 2 DM with DKA without coma. Precipitating factors: Infection. Lab results: pH 7.28, glucose 320 mg/dL.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Diabetic crisis with high sugars
Good Documentation Example
Type 2 diabetes with ketoacidosis (pH 7.12, serum β-hydroxybutyrate 4.8 mmol/L) secondary to pump malfunction, alert and oriented
Explanation
The good example provides specific details about the type of diabetes, lab results, and precipitating factors, which are necessary for accurate coding.

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