ICD-10 Coding for Elevated Blood Glucose(R73.01, R73.03, E11.65)
Complete ICD-10-CM coding and documentation guide for Elevated Blood Glucose. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Blood Glucose
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R73.01 | Impaired fasting glucose | Use when fasting glucose levels are elevated but not diagnostic of diabetes. |
|
| R73.03 | Prediabetes | Use when A1C levels indicate prediabetes. |
|
| E11.65 | Type 2 diabetes mellitus with hyperglycemia | Use when hyperglycemia is documented in a patient with type 2 diabetes. |
|
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 elevated blood glucose
Essential facts and insights about Elevated Blood Glucose
Primary ICD-10-CM Codes for elevated blood glucose
Decision Criteria
clinical Criteria
- Fasting glucose between 100-125 mg/dL
Applicable To
- Fasting glucose 100-125 mg/dL
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- Fasting plasma glucose between 100-125 mg/dL
Code-Specific Risks
- Misclassification if diabetes is not ruled out.
Coding Notes
- Ensure fasting glucose levels are documented.
R73.03 - Prediabetes
Use when A1C levels indicate prediabetes.
Applicable To
- A1C 5.7-6.4%
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- A1C between 5.7-6.4%
Coding Notes
Document A1C levels clearly.
E11.65 - Type 2 diabetes mellitus with hyperglycemia
Use when hyperglycemia is documented in a patient with type 2 diabetes.
Applicable To
- Type 2 diabetes with documented hyperglycemia
Excludes
- Type 1 diabetes mellitus (E10.-)
Clinical Validation Requirements
- Random glucose >200 mg/dL with symptoms
Coding Notes
Link hyperglycemia to diabetes explicitly in documentation.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Elevated Blood Glucose to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R73.01.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Train staff on specific documentation requirements., Use templates to ensure completeness.
Impact
Reimbursement: May result in lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases data accuracy and quality.
Mitigation Strategy
Use specific codes like R73.01 or R73.03 when criteria are met.
Impact
Reimbursement: Incorrect coding can affect reimbursement rates., Compliance: Violates coding rules requiring provider documentation., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Ensure provider documents hyperglycemia explicitly.
Impact
Risk of audits if hyperglycemia is not clearly documented.
Mitigation Strategy
Ensure all instances of hyperglycemia are linked to diabetes in documentation.
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 Elevated Blood Glucose, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Blood Glucose
Use these documentation templates to ensure complete and accurate documentation for Elevated Blood Glucose. These templates include all required elements for proper coding and billing.
Follow-up for elevated glucose
Specialty: EndocrinologyRequired Elements
- Patient history
- Current glucose levels
- Symptoms
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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