ICD-10 Coding for Diabetic Neuropathy(E11.42, E11.40)
Complete ICD-10-CM coding and documentation guide for Diabetic Neuropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetic Neuropathy
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy | Use when documenting type 2 diabetes with confirmed polyneuropathy. |
|
| E11.40 | Type 2 diabetes mellitus with diabetic neuropathy, unspecified | Use when neuropathy is documented but not specified as poly or mononeuropathy. |
|
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 neuropathy
Essential facts and insights about Diabetic Neuropathy
Primary ICD-10-CM Codes for diabetic neuropathy
Decision Criteria
clinical Criteria
- Presence of bilateral sensory loss confirmed by testing
documentation Criteria
- Explicit mention of polyneuropathy due to diabetes
Applicable To
- Type 2 diabetes with polyneuropathy
Excludes
- Diabetic mononeuropathy (E11.41)
Clinical Validation Requirements
- Nerve conduction studies showing reduced velocity
- Monofilament testing indicating sensory loss
Code-Specific Risks
- Misclassification if neuropathy type is not specified
Coding Notes
- Ensure documentation specifies polyneuropathy and links it to diabetes.
E11.40 - Type 2 diabetes mellitus with diabetic neuropathy, unspecified
Use when neuropathy is documented but not specified as poly or mononeuropathy.
Applicable To
- Type 2 diabetes with unspecified neuropathy
Excludes
- Diabetic polyneuropathy (E11.42)
Clinical Validation Requirements
- General neuropathy symptoms without specific testing
Coding Notes
Avoid using this code if specific neuropathy type is known.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Diabetic polyneuropathy
G63.2Differential 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 Diabetic Neuropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.42.
Impact
Clinical: May lead to incorrect treatment plans, Regulatory: Increases risk of non-compliance, Financial: Potential for denied claims
Mitigation Strategy
Always document the causal relationship, Use phrases like 'due to diabetes'
Impact
Reimbursement: May lead to lower reimbursement rates, Compliance: Increases risk of coding audits, Data Quality: Reduces accuracy of clinical data
Mitigation Strategy
Ensure documentation specifies the type of neuropathy and use the corresponding specific code.
Impact
High risk of audit if neuropathy type is not specified
Mitigation Strategy
Ensure documentation includes specific neuropathy type and related tests.
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 Neuropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetic Neuropathy
Use these documentation templates to ensure complete and accurate documentation for Diabetic Neuropathy. These templates include all required elements for proper coding and billing.
Diabetic Neuropathy with Polyneuropathy
Specialty: EndocrinologyRequired Elements
- Type of diabetes
- Description of neuropathy symptoms
- Results of nerve conduction studies
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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