ICD-10 Coding for Elevated Glycosylated Hemoglobin(R73.09, E11.65)
Complete ICD-10-CM coding and documentation guide for Elevated Glycosylated Hemoglobin. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Glycosylated Hemoglobin
E08-E13Primary Range
Diabetes mellitus
This range includes codes for diabetes mellitus, which is often associated with elevated glycosylated hemoglobin.
Elevated blood glucose level
This range includes codes for elevated blood glucose levels, which can include elevated HbA1c without a diabetes diagnosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R73.09 | Other abnormal glucose | Use when HbA1c is elevated but there is no documented diabetes diagnosis. |
|
| 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 glycosylated hemoglobin
Essential facts and insights about Elevated Glycosylated Hemoglobin
Primary ICD-10-CM Codes for elevated glycosylated hemoglobin
Decision Criteria
clinical Criteria
- HbA1c level is elevated but no diabetes diagnosis is documented.
Applicable To
- Elevated HbA1c without diabetes diagnosis
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- HbA1c level above normal range without diabetes diagnosis
Code-Specific Risks
- Misclassification if diabetes is present but not documented
Coding Notes
- Ensure no diabetes diagnosis is present when using this code.
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
- Provider documentation linking hyperglycemia to diabetes
- HbA1c ≥6.5%
Coding Notes
Ensure hyperglycemia is explicitly documented by the provider.
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 Elevated Glycosylated Hemoglobin to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R73.09.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Potential audit risk., Financial: Loss of appropriate reimbursement.
Mitigation Strategy
Review provider notes for hyperglycemia documentation, Query provider if unclear
Impact
Reimbursement: Incorrect coding may lead to reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure provider documentation explicitly states hyperglycemia.
Impact
Lack of explicit documentation for hyperglycemia can lead to audit issues.
Mitigation Strategy
Ensure provider notes clearly state hyperglycemia.
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 Glycosylated Hemoglobin, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Glycosylated Hemoglobin
Use these documentation templates to ensure complete and accurate documentation for Elevated Glycosylated Hemoglobin. These templates include all required elements for proper coding and billing.
Endocrinology follow-up for elevated HbA1c
Specialty: EndocrinologyRequired Elements
- Patient symptoms
- HbA1c levels
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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