ICD Code E11.51

ICD code E11.51 is used to classify a diagnosis of Type 2 diabetes mellitus where the patient also has diabetic peripheral angiopathy, which is a condition affecting the blood vessels in the extremities, but without the presence of gangrene. This code helps healthcare providers document and communicate the specific complications associated with a patient's diabetes, ensuring accurate treatment and billing.

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

2. Presence of Peripheral Angiopathy: Identify the presence of peripheral angiopathy, which involves damage to the blood vessels outside of the heart and brain. This condition is often associated with diabetes and can lead to reduced blood flow, particularly in the extremities.

3. Absence of Gangrene: Ensure that there is no presence of gangrene. Gangrene is a serious condition that occurs when a considerable mass of body tissue dies due to a lack of blood supply or a bacterial infection. The absence of gangrene is crucial for using this specific code.

4. Clinical Symptoms: Document any clinical symptoms that support the diagnosis of diabetic peripheral angiopathy. These may include, but are not limited to, intermittent claudication, cold feet, numbness, tingling, or pain in the extremities.

5. Diagnostic Tests: Utilize diagnostic tests to confirm peripheral angiopathy. This may include Doppler ultrasound, ankle-brachial index (ABI), or other vascular studies that demonstrate reduced blood flow or vessel abnormalities.

6. Exclusion of Other Causes: Rule out other potential causes of peripheral angiopathy symptoms that are not related to diabetes, ensuring that the condition is indeed a complication of Type 2 diabetes mellitus.

By following these criteria, healthcare providers can accurately document and code for Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene, ensuring proper billing and reimbursement processes.

For the ICD code E11.51, which pertains to Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene, the relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99215: Evaluation and Management (E/M) services for new or established patients, which can be used for office or other outpatient visits.

2. 93922: Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral (e.g., ankle/brachial indices, Doppler waveform analysis, volume plethysmography, transcutaneous oxygen tension measurement).

3. 93923: Noninvasive physiologic studies of upper or lower extremity arteries, multiple levels or with provocative functional maneuvers, complete bilateral study.

4. 93924: Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, complete bilateral study.

5. G0108: Diabetes outpatient self-management training services, individual, per 30 minutes.

6. G0109: Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes.

7. 97802: Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes.

8. 97803: Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes.

9. 97804: Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes.

These CPT codes are examples of the types of services that may be relevant for managing and treating the condition associated with ICD code E11.51. It's important for healthcare providers to select the appropriate CPT codes based on the specific services rendered and the individual patient's treatment plan.

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