ICD Code E11.65

ICD code E11.65 is used to classify a diagnosis of Type 2 diabetes mellitus with hyperglycemia. This code indicates that the patient has Type 2 diabetes, a chronic condition affecting the way the body processes blood sugar (glucose), and is experiencing higher than normal levels of glucose in the blood, known as hyperglycemia. This code is crucial for healthcare providers to accurately document the patient's 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 is often associated with obesity and a sedentary lifestyle.

2. Presence of Hyperglycemia: Identify that the patient is experiencing hyperglycemia, which is an elevated level of glucose in the blood. This can be determined through blood tests such as fasting blood glucose, oral glucose tolerance test, or HbA1c levels.

3. Exclusion of Other Types of Diabetes: Ensure that other types of diabetes, such as Type 1 diabetes or gestational diabetes, have been ruled out. This is important to accurately apply the correct ICD code.

4. Assessment of Symptoms: Evaluate symptoms that may indicate hyperglycemia, including frequent urination, increased thirst, blurred vision, fatigue, and headaches.

5. Review of Medical History: Consider the patient's medical history, including any previous episodes of hyperglycemia or related complications, to support the diagnosis.

6. Monitoring and Documentation: Ensure that the hyperglycemic condition is being actively monitored and documented in the patient's medical records, as this supports the use of the ICD code for billing and treatment purposes.

7. Treatment Plan: Confirm that a treatment plan is in place to manage both the Type 2 diabetes and the hyperglycemia, which may include lifestyle modifications, medication, or insulin therapy.

For the ICD code E11.65, which pertains to type 2 diabetes mellitus with hyperglycemia, the relevant CPT codes that may be applicable for treatment and management include:

1. 82947 - Glucose; quantitative, blood (except reagent strip)

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

These CPT codes are commonly used in the management and monitoring of diabetes and its complications, including hyperglycemia. It's important for healthcare providers to select the appropriate CPT codes based on the specific services rendered to ensure accurate billing and reimbursement.

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