ICD-10 Coding for Diabetic Ketoacidosis(E10.10, E11.10)
Complete ICD-10-CM coding and documentation guide for Diabetic Ketoacidosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetic Ketoacidosis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E10.10 | Type 1 diabetes mellitus with ketoacidosis without coma | Use when a patient with type 1 diabetes presents with ketoacidosis without coma. |
|
| E11.10 | Type 2 diabetes mellitus with ketoacidosis without coma | Use when a patient with type 2 diabetes presents with ketoacidosis without coma. |
|
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 diabetic ketoacidosis
Essential facts and insights about Diabetic Ketoacidosis
Primary ICD-10-CM Codes for diabetic ketoacidosis
Decision Criteria
clinical Criteria
- Presence of ketoacidosis symptoms in a type 1 diabetic patient.
Applicable To
- Type 1 diabetes with ketoacidosis
Excludes
- Lactic acidosis (E87.2)
Clinical Validation Requirements
- Blood glucose >250 mg/dL
- pH ≤7.3
- Bicarbonate ≤15 mmol/L
- Ketonemia
Code-Specific Risks
- Ensure correct differentiation from lactic acidosis.
Coding Notes
- Ensure documentation specifies type of diabetes and presence of ketoacidosis.
E11.10 - Type 2 diabetes mellitus with ketoacidosis without coma
Use when a patient with type 2 diabetes presents with ketoacidosis without coma.
Applicable To
- Type 2 diabetes with ketoacidosis
Excludes
- Lactic acidosis (E87.2)
Clinical Validation Requirements
- Blood glucose >250 mg/dL
- pH ≤7.3
- Bicarbonate ≤15 mmol/L
- Ketonemia
Coding Notes
Ensure documentation specifies type of diabetes and presence of ketoacidosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified abnormal findings of blood chemistry
R79.89Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Acidosis
E87.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetic Ketoacidosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E10.10.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Use specific terms like 'ketoacidosis' and include lab values.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use O24.419 for gestational diabetes with DKA and E87.2 for acidosis.
Impact
Failure to sequence diabetes type before complications.
Mitigation Strategy
Educate coding staff on proper sequencing rules.
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 Diabetic Ketoacidosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetic Ketoacidosis
Use these documentation templates to ensure complete and accurate documentation for Diabetic Ketoacidosis. These templates include all required elements for proper coding and billing.
Emergency Department Admission for DKA
Specialty: Emergency MedicineRequired Elements
- Patient's diabetes type
- Presence of ketoacidosis
- Precipitating factors
- Lab results (pH, glucose, ketones)
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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