ICD Code E16.2

ICD code E16.2 is used to classify and code a diagnosis of hypoglycemia when the specific cause or type is not identified. Hypoglycemia refers to an abnormally low level of glucose in the blood, which can lead to symptoms such as shakiness, confusion, and in severe cases, loss of consciousness. This code is utilized when the healthcare provider has determined that the patient is experiencing hypoglycemia, but further details about the underlying cause or specific condition are not available or specified in the medical record.

1. Blood Glucose Levels: Use the ICD code when blood glucose levels are measured below the normal range, typically less than 70 mg/dL, without a clear cause or specific condition identified.

2. Symptoms of Hypoglycemia: Document the presence of symptoms such as shakiness, sweating, confusion, irritability, dizziness, hunger, or headache that are consistent with low blood sugar levels.

3. Absence of Known Causes: Ensure that the hypoglycemic episode is not attributable to known causes such as insulin overdose, excessive alcohol consumption, or other identifiable medical conditions.

4. Recurrent Episodes: Consider using the code if the patient experiences recurrent episodes of hypoglycemia without a specific diagnosis or underlying condition being determined.

5. Medical Evaluation: The code is applicable when a thorough medical evaluation has been conducted, and no specific type of hypoglycemia (e.g., reactive, fasting) has been diagnosed.

6. Documentation: Ensure that the medical records clearly document the hypoglycemic event and the lack of a specific diagnosis, supporting the use of an unspecified code.

7. Clinical Judgment: Utilize clinical judgment to determine if the unspecified code is appropriate when the hypoglycemic episodes do not fit into other specific categories or diagnoses.

For the ICD code E16.2 (Hypoglycemia, unspecified), the relevant CPT codes that may be applicable for treatment and management include:

1. 82948 - Glucose; blood, reagent strip

2. 82962 - Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use

3. 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

4. 95251 - Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation, and report

5. 96372 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

These CPT codes are typically used in the context of diagnosing, monitoring, and managing conditions related to hypoglycemia. It is important for healthcare providers to select the appropriate CPT codes based on the specific services rendered and the clinical context.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments for CPT codes associated with ICD code E16.2. Schedule a demo today to see how RevFind can help ensure you're receiving the full reimbursement you deserve.