Valid for Submission
E13.11 is a billable diagnosis code used to specify a medical diagnosis of other specified diabetes mellitus with ketoacidosis with coma. The code E13.11 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The code E13.11 is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%) , Diabetes: Eye Exam.
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.
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code E13.11 are found in the index:
Convert E13.11 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code E13.11 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Quality Payment Program Measures
When code E13.11 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, Electronichealthrecord, Cmswebinterface, Registry|
|Diabetes: Eye Exam||Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy overlapping 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 overlapping 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, Electronichealthrecord, Registry|
Information for Patients
A coma is a deep state of unconsciousness. An individual in a coma is alive but unable to move or respond to his or her environment. Coma may occur as a complication of an underlying illness, or as a result of injuries, such as brain injury.
A coma rarely lasts more than 2 to 4 weeks. The outcome for coma depends on the cause, severity, and site of the damage. People may come out of a coma with physical, intellectual, and psychological problems. Some people may remain in a coma for years or even decades. For those people, the most common cause of death is infection, such as pneumonia.
NIH: National Institute of Neurological Disorders and Stroke
- EEG (Medical Encyclopedia)
[Learn More in MedlinePlus]
Also called: DM, Diabetes mellitus
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
- A1C test (Medical Encyclopedia)
- Blood sugar test - blood (Medical Encyclopedia)
- Diabetes (Medical Encyclopedia)
- Diabetes - keeping active (Medical Encyclopedia)
- Diabetes - low blood sugar - self-care (Medical Encyclopedia)
- Diabetes - tests and checkups (Medical Encyclopedia)
- Diabetes - when you are sick (Medical Encyclopedia)
- Diabetes and exercise (Medical Encyclopedia)
- Diabetes myths and facts (Medical Encyclopedia)
- Giving an insulin injection (Medical Encyclopedia)
- High blood sugar - self-care (Medical Encyclopedia)
[Learn More in MedlinePlus]