2024 ICD-10-CM Diagnosis Code E13.9

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Acquired partial lipodystrophy
• Acrorenal field defect, ectodermal dysplasia, and lipoatrophic diabetes
• Agenesis of cerebellum
• Atypical diabetes mellitus
• Congenital hypoplasia of pancreas
• Diabetes mellitus associated with hormonal etiology
• Diabetes mellitus associated with pancreatic disease
• Diabetes mellitus associated with receptor abnormality
• Diabetes mellitus caused by chemical
• Diabetes mellitus due to genetic defect in beta cell function
• Diabetes mellitus due to genetic defect in insulin action
• Diabetes mellitus due to insulin receptor antibodies
• Diabetes mellitus due to structurally abnormal insulin
• Houssay's syndrome
• Intellectual disability, craniofacial dysmorphism, hypogonadism, diabetes mellitus syndrome
• Lipodystrophy, partial, with Rieger anomaly, short stature, and insulinopenic diabetes mellitus
• Malnutrition related diabetes mellitus
• Maturity onset diabetes of the young, type 1
• Maturity-onset diabetes of the young
• Maturity-onset diabetes of the young, type 10
• Maturity-onset diabetes of the young, type 11
• Maturity-onset diabetes of the young, type 3
• Maturity-onset diabetes of the young, type 4
• Maturity-onset diabetes of the young, type 5
• Maturity-onset diabetes of the young, type 6
• Maturity-onset diabetes of the young, type 7
• Maturity-onset diabetes of the young, type 8
• Maturity-onset diabetes of the young, type 9
• Mild intellectual disability
• Muscular atrophy, ataxia, retinitis pigmentosa, and diabetes mellitus
• Neonatal diabetes mellitus
• Neonatal diabetes mellitus
• Pancreatic hypoplasia, diabetes mellitus, congenital heart disease syndrome
• Permanent neonatal diabetes mellitus
• Permanent neonatal diabetes mellitus
• Permanent neonatal diabetes mellitus with cerebellar agenesis syndrome
• Pre-existing diabetes mellitus in pregnancy
• Pre-existing malnutrition-related diabetes mellitus
• Pre-existing malnutrition-related diabetes mellitus in pregnancy
• Primary microcephaly, mild intellectual disability, young-onset diabetes syndrome
• Secondary diabetes mellitus
• Secondary endocrine diabetes mellitus

Clinical Information

• Permanent Neonatal Diabetes Mellitus

  hyperglycemia in the first month of life due to a genetically determined defect in the structure, secretion and/or function of insulin that does not resolve spontaneously.

• Acquired Partial Lipodystrophy

  partial lipodystrophy, the cause of which is not present at birth. examples include lipodystrophy associated with human immunodeficiency virus (hiv) therapy, and barraquer-simons syndrome, associated with c3 nephritic factor.

Coding Guidelines

The diabetes mellitus codes are combination codes that include the type of diabetes mellitus, the body system affected, and the complications affecting that body system. As many codes within a particular category as are necessary to describe all of the complications of the disease may be used. They should be sequenced based on the reason for a particular encounter. Assign as many codes from categories E08 - E13 as needed to identify all of the associated conditions that the patient has.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

• Questionable admission codes - Some diagnoses are not usually sufficient justification for admission to an acute care hospital. For example, if a patient is given code R030 for elevated blood pressure reading, without diagnosis of hypertension, then the patient would have a questionable admission, since elevated blood pressure reading is not normally sufficient justification for admission to a hospital. The following list contains diagnosis codes identified as questionable admission when used.

Convert E13.9 to ICD-9-CM

• ICD-9-CM Code: 249.00 - Sec DM wo cmp nt st uncn
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
• ICD-9-CM Code: 250.00 - DMII wo cmp nt st uncntr
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Quality Payment Program Measures

When code E13.9 is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.

Quality Measure	Description	Quality Domain	Measure Type	High Priority	Submission Methods
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)	Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period.	Effective Clinical Care	Intermediateoutcome	YES	Claims, Electronic Health Record, Cms Web Interface, Registry
Diabetes: Eye Exam	Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period.	Effective Clinical Care	Process	NO	Claims, Electronic Health Record, Registry

Patient Education

Diabetes

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.

Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your blood glucose level and take medicine if prescribed.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

[Learn More in MedlinePlus]

Diabetes Overview

Overview of diabetes, including: risk factors, prevention of type 2 diabetes, insulin and other treatments, diabetes diet, eating , and physical activity.
[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.