ICD Code E11.9

ICD code E11.9 is used to classify a diagnosis of Type 2 diabetes mellitus without any noted complications. This code is part of the International Classification of Diseases, 10th Revision (ICD-10), which is used by healthcare providers to document and report diseases and health conditions. Specifically, E11.9 indicates that the patient has Type 2 diabetes, a chronic condition affecting the way the body processes blood sugar (glucose), but does not currently exhibit any additional complications such as neuropathy, retinopathy, or nephropathy that are often associated with diabetes. This code is crucial for accurate medical billing and ensures that healthcare providers are reimbursed appropriately for the care provided to patients with this condition.

1. Elevated Blood Glucose Levels: Persistent hyperglycemia, typically indicated by fasting blood glucose levels of 126 mg/dL or higher, or an HbA1c level of 6.5% or higher.

2. Insulin Resistance: Evidence of the body's inability to effectively use insulin, often assessed through clinical evaluation and laboratory tests.

3. Absence of Acute or Chronic Complications: No evidence of complications such as neuropathy, retinopathy, nephropathy, or cardiovascular issues directly related to diabetes.

4. Polyuria and Polydipsia: Frequent urination and increased thirst, common symptoms associated with elevated blood sugar levels.

5. Unexplained Weight Loss: Sudden or unexplained weight loss despite normal or increased appetite.

6. Fatigue and Weakness: Persistent feelings of tiredness and lack of energy, often due to the body's inability to utilize glucose effectively.

7. Family History: A family history of diabetes, which may increase the likelihood of developing the condition.

8. Obesity or Overweight: A body mass index (BMI) of 25 or higher, which is a significant risk factor for developing type 2 diabetes.

9. Sedentary Lifestyle: Lack of physical activity, contributing to insulin resistance and weight gain.

10. Age and Ethnicity: Being over the age of 45 or belonging to certain ethnic groups, such as African American, Hispanic, Native American, or Asian American, which have a higher predisposition to type 2 diabetes.

11. History of Gestational Diabetes: A history of gestational diabetes or delivering a baby weighing more than 9 pounds.

12. Hypertension and Dyslipidemia: Coexisting conditions such as high blood pressure and abnormal cholesterol levels, which are often associated with type 2 diabetes.

For the ICD code E11.9, which is Type 2 diabetes mellitus without complications, the relevant CPT codes that may be applicable include:

1. 99201-99215: These codes are for office or other outpatient visits for the evaluation and management of a patient. The specific code within this range would depend on the complexity and time spent during the visit.

2. 82947: Glucose; quantitative, blood (except reagent strip).

3. 82948: Glucose; blood, reagent strip.

4. 82962: Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use.

5. 83036: Hemoglobin; glycosylated (A1c).

6. 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.

7. 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 patients with Type 2 diabetes mellitus without complications. The selection of specific codes would depend on the services provided during the patient encounter.

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