ICD-10 Coding for Diabetic Polyneuropathy(E10.42, E11.42, E13.42)
Complete ICD-10-CM coding and documentation guide for Diabetic Polyneuropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetic Polyneuropathy
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E10.42 | Type 1 diabetes mellitus with diabetic polyneuropathy | Use when documenting Type 1 diabetes with confirmed polyneuropathy. |
|
| E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy | Use when documenting Type 2 diabetes with confirmed polyneuropathy. |
|
| E13.42 | Other specified diabetes mellitus with diabetic polyneuropathy | Use for specified diabetes types other than Type 1 or Type 2 with polyneuropathy. |
|
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 polyneuropathy
Essential facts and insights about Diabetic Polyneuropathy
Primary ICD-10-CM Codes for diabetic polyneuropathy
Decision Criteria
clinical Criteria
- Bilateral symptoms and confirmed diabetes
Applicable To
- Type 1 diabetes with nerve damage
Excludes
- Diabetic mononeuropathy (E10.41)
Clinical Validation Requirements
- Bilateral symptoms such as numbness or tingling
- Abnormal monofilament test
- Reduced ankle reflexes
Code-Specific Risks
- Ensure documentation specifies 'polyneuropathy' and links it to diabetes.
Coding Notes
- Ensure the type of diabetes is specified; if not, default to Type 2.
E11.42 - Type 2 diabetes mellitus with diabetic polyneuropathy
Use when documenting Type 2 diabetes with confirmed polyneuropathy.
Applicable To
- Type 2 diabetes with nerve damage
Excludes
- Diabetic mononeuropathy (E11.41)
Clinical Validation Requirements
- Bilateral symptoms such as numbness or tingling
- Abnormal monofilament test
- Reduced ankle reflexes
Coding Notes
Ensure the type of diabetes is specified; if not, default to Type 2.
E13.42 - Other specified diabetes mellitus with diabetic polyneuropathy
Use for specified diabetes types other than Type 1 or Type 2 with polyneuropathy.
Applicable To
- Other specified diabetes with nerve damage
Excludes
- Diabetic mononeuropathy (E13.41)
Clinical Validation Requirements
- Bilateral symptoms such as numbness or tingling
- Abnormal monofilament test
- Reduced ankle reflexes
Coding Notes
Ensure the type of diabetes is specified; if not, default to Type 2.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of insulin
Z79.4Differential 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 Polyneuropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E10.42.
Impact
Clinical: Inaccurate patient records., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Educate providers on documentation requirements., Use templates to guide documentation.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Poor data quality affecting patient records.
Mitigation Strategy
Specify 'diabetic polyneuropathy' and link it to diabetes.
Impact
Lack of specificity in documentation can lead to audits.
Mitigation Strategy
Ensure detailed documentation linking symptoms to diabetes.
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 Polyneuropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetic Polyneuropathy
Use these documentation templates to ensure complete and accurate documentation for Diabetic Polyneuropathy. These templates include all required elements for proper coding and billing.
Bilateral foot numbness in diabetic patient
Specialty: NeurologyRequired Elements
- Bilateral symptoms
- Monofilament test results
- Diabetes type and control status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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