Risk Coding

Risk Coding Tip – Dec 2021

Type 2 Diabetes Mellitus with Complications

When coding for patients with diabetes, it is very important to use codes that account for the whole clinical picture—especially the complications associated with diabetes.  Start with E11, the code for diabetes, and use the digits following the decimal point to increase your specificity:

Fourth Digit Body Region Example
of ICD 10
Description RAF Additional Information
2 Kidney complications E11.22 Type 2 diabetes with chronic kidney disease 0.302 Still need to code the kidney stage, e.g., N18.31
3 Vision complications E11.311 Type 2 diabetes with diabetic retinopathy and macular edema 0.302  
4 Neurological complications E11.42 Type 2 diabetes with polyneuropathy 0.302  
5 Circulatory complications E11.51 Type 2 diabetes with peripheral vascular complications 0.302  
6 Other specified complications E11.65 Type 2 diabetes with hyperglycemia 0.302 Recommended to use when your patient has “uncontrolled” Type 2 diabetes.
9 Unspecified E11.9 Type 2 diabetes, with no complication 0.105