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ICD-10 Coding for Glucose Tolerance Disorders(R73.09, E11.65)

Complete ICD-10-CM coding and documentation guide for Glucose Tolerance Disorders. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Impaired Glucose TolerancePrediabetesAbnormal Glucose

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Related ICD-10 Code Ranges

Complete code families applicable to Glucose Tolerance Disorders

R73-R73.9Primary Range

Abnormal glucose levels

Covers conditions related to abnormal glucose levels, including prediabetes and impaired glucose tolerance.

E10-E13

Diabetes mellitus

Includes various types of diabetes, which may be relevant if glucose tolerance progresses to diabetes.

O24

Diabetes mellitus in pregnancy

Relevant for gestational diabetes and pre-existing diabetes in pregnancy.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
R73.09Other abnormal glucoseUse when lab results indicate impaired glucose tolerance or prediabetes without a diagnosis of diabetes.
  • Fasting glucose 100-125 mg/dL
  • 2-hour OGTT 140-199 mg/dL
  • A1C 5.7-6.4%
E11.65Type 2 diabetes mellitus with hyperglycemiaUse when hyperglycemia is documented in a patient with type 2 diabetes.
  • Random glucose >200 mg/dL with symptoms

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 impaired glucose tolerance

Essential facts and insights about Glucose Tolerance Disorders

The ICD-10 code for impaired glucose tolerance is R73.09, covering prediabetes and abnormal glucose levels.

Primary ICD-10-CM Codes for glucose tolerance

R73.09
Other abnormal glucose
Billable Code

Decision Criteria

clinical Criteria

  • Fasting glucose 100-125 mg/dL or 2-hour OGTT 140-199 mg/dL

documentation Criteria

  • Document specific lab results and test dates

Applicable To

  • Impaired glucose tolerance
  • Prediabetes

Excludes

Clinical Validation Requirements

  • Fasting glucose 100-125 mg/dL
  • 2-hour OGTT 140-199 mg/dL
  • A1C 5.7-6.4%

Code-Specific Risks

  • Misclassification if diabetes criteria are met
  • Use of unspecified codes when specific criteria are met

Coding Notes

  • Ensure documentation includes specific lab values and test types to support the use of R73.09.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Encounter for general adult medical examination without abnormal findings

Z00.00
Use for screening encounters where abnormal glucose is identified.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Type 2 diabetes mellitus without complications

E11.9
Use E11.9 if criteria for diabetes are met (e.g., A1C ≥6.5%).

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Glucose Tolerance Disorders to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R73.09.

Impact

Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Increases risk of non-compliance with coding standards., Financial: Potential for reduced reimbursement.

Mitigation Strategy

Use specific lab values in documentation., Train staff on documentation standards.

Impact

Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit failures., Data Quality: Reduces specificity and accuracy of clinical data.

Mitigation Strategy

Use R73.09 when specific criteria for impaired glucose tolerance are met.

Impact

Increased audit risk when using unspecified codes for glucose abnormalities.

Mitigation Strategy

Use specific codes like R73.09 when criteria are met.

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 Glucose Tolerance Disorders, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Glucose Tolerance Disorders

Use these documentation templates to ensure complete and accurate documentation for Glucose Tolerance Disorders. These templates include all required elements for proper coding and billing.

Outpatient glucose tolerance evaluation

Specialty: Endocrinology

Required Elements

  • Glucose status
  • Diagnostic basis
  • Symptom correlation
  • Complication status
  • Management plan

Example Documentation

Patient presents with fasting glucose 112 mg/dL and 2-hr OGTT 148 mg/dL, meeting criteria for impaired glucose tolerance (R73.09). No diabetic complications observed.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has slightly high sugar levels.
Good Documentation Example
Patient presents with fasting glucose 112 mg/dL and 2-hr OGTT 148 mg/dL, meeting criteria for impaired glucose tolerance (R73.09).
Explanation
The good example provides specific lab values and meets criteria for R73.09.

Need help with ICD-10 coding for Glucose Tolerance Disorders? Ask your questions below.

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