ICD-10 E11.9: Type 2 diabetes mellitus without complications
Adult-onset diabetes without documented end-organ damage. Most common diabetes code in primary care.
Clinical context
Adult-onset diabetes without documented end-organ damage. Most common diabetes code in primary care.
Documentation requirements
- Diagnostic criteria met (HbA1c ≥6.5%, FPG ≥126, OGTT ≥200, random ≥200 with symptoms)
- Type clarification (Type 2 vs Type 1)
- Absence of complications explicitly noted
Common related procedures
- 83036 HbA1c
- 82948 glucose
- 82570 creatinine
- 84443 TSH
Common payer denial patterns
- HbA1c >4x/year requires specific documentation of uncontrolled status
- CGM (95251) denied without prior PA
Frequently asked questions
What does ICD-10 E11.9 mean?
Type 2 diabetes mellitus without complications
When is this code documented?
Adult-onset diabetes without documented end-organ damage. Most common diabetes code in primary care.
What documentation supports this code?
Diagnostic criteria met (HbA1c ≥6.5%, FPG ≥126, OGTT ≥200, random ≥200 with symptoms); Type clarification (Type 2 vs Type 1); Absence of complications explicitly noted.
What are common denials associated with this diagnosis?
HbA1c >4x/year requires specific documentation of uncontrolled status; CGM (95251) denied without prior PA.
Related diagnoses
Sources
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