ICD Code E11.10

ICD code E11.10 is used to classify a diagnosis of Type 2 diabetes mellitus where the patient is experiencing ketoacidosis, a serious complication characterized by high levels of ketones in the blood, but without the presence of a coma. This code is crucial for healthcare providers to accurately document the condition for treatment planning and billing purposes.

1. Diagnosis of Type 2 Diabetes Mellitus: Confirm that the patient has been diagnosed with Type 2 diabetes mellitus. This is typically characterized by insulin resistance and relative insulin deficiency.

2. Presence of Ketoacidosis: Identify the presence of ketoacidosis, which is a serious diabetes complication where the body produces excess blood acids (ketones). This is usually indicated by symptoms such as nausea, vomiting, abdominal pain, and a fruity-scented breath.

3. Absence of Coma: Ensure that the patient is not experiencing a diabetic coma. While ketoacidosis can lead to a coma if untreated, this specific code is used when ketoacidosis is present without the patient being in a coma.

4. Laboratory Confirmation: Obtain laboratory results that confirm elevated ketone levels in the blood or urine, along with high blood glucose levels, to substantiate the diagnosis of ketoacidosis.

5. Exclusion of Other Conditions: Rule out other potential causes of ketoacidosis, such as Type 1 diabetes or other metabolic disorders, to ensure accurate coding.

6. Clinical Documentation: Ensure that the clinical documentation clearly supports the diagnosis of Type 2 diabetes mellitus with ketoacidosis without coma, as accurate documentation is crucial for proper coding and billing.

For the ICD code E11.10, which pertains to Type 2 diabetes mellitus with ketoacidosis without coma, the relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99215: Evaluation and Management (E/M) codes for office or other outpatient visits, depending on the complexity and time spent with the patient.

2. 82948: Glucose; blood, reagent strip.

3. 82962: Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use.

4. 83036: Hemoglobin; glycosylated (A1c).

5. 95250: Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up, calibration of monitor, patient training, and printout of recording.

6. 95251: Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation, and report.

7. 96365-96368: Intravenous infusion codes for the administration of fluids and/or medications, which may be necessary for the treatment of ketoacidosis.

8. 36415: Collection of venous blood by venipuncture, which may be required for laboratory testing.

These CPT codes are examples of the procedures and services that might be utilized in the management and treatment of a patient with the condition associated with ICD code E11.10. It is important for healthcare providers to select the appropriate CPT codes based on the specific services rendered and the clinical scenario.

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