ICD-10 Coding for Personal History of Diabetes(Z86.32, Z86.39)
Complete ICD-10-CM coding and documentation guide for Personal History of Diabetes. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Personal History of Diabetes
Z86.3Primary Range
Personal history of endocrine, nutritional and metabolic diseases
This range includes codes for documenting resolved conditions related to endocrine, nutritional, and metabolic diseases, including diabetes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z86.32 | Personal history of gestational diabetes | Use for patients with a history of gestational diabetes who are not currently pregnant. |
|
| Z86.39 | Personal history of other endocrine, nutritional and metabolic diseases | Use for patients with resolved diabetes, indicated by normal HbA1c levels and no current treatment. |
|
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 personal history of diabetes
Essential facts and insights about Personal History of Diabetes
Primary ICD-10-CM Codes for personal history of diabetes
Decision Criteria
clinical Criteria
- Patient has a history of gestational diabetes but is not currently pregnant.
Applicable To
- Resolved gestational diabetes in non-pregnant women
Excludes
- Current gestational diabetes (O24.4)
Clinical Validation Requirements
- No current hyperglycemia
- Not pregnant
Code-Specific Risks
- Incorrectly coding active gestational diabetes as history
Coding Notes
- Ensure the patient is not currently pregnant when using this code.
Z86.39 - Personal history of other endocrine, nutritional and metabolic diseases
Use for patients with resolved diabetes, indicated by normal HbA1c levels and no current treatment.
Applicable To
- Resolved type 1 or type 2 diabetes
Excludes
- Active diabetes (E10-E11)
Clinical Validation Requirements
- HbA1c <6.5% for at least one year without medication
- Documentation of 'resolved' or 'in remission'
Coding Notes
Ensure documentation clearly states the diabetes is resolved.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Personal History of Diabetes to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.32.
Impact
Clinical: Misrepresents patient's current health status., Regulatory: Non-compliance with coding standards., Financial: Potential for incorrect billing.
Mitigation Strategy
Review current treatment and lab results., Ensure documentation reflects current status.
Impact
Reimbursement: Incorrect coding can lead to improper reimbursement., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects the accuracy of patient health records.
Mitigation Strategy
Verify current treatment and HbA1c levels to confirm resolution.
Impact
Risk of coding errors when diabetes is not truly resolved.
Mitigation Strategy
Regularly review patient records for accuracy.
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 Personal History of Diabetes, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Personal History of Diabetes
Use these documentation templates to ensure complete and accurate documentation for Personal History of Diabetes. These templates include all required elements for proper coding and billing.
Resolved Type 2 Diabetes
Specialty: EndocrinologyRequired Elements
- Diabetes type
- Date of resolution
- Current HbA1c
- Treatment history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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