2024 ICD-10-CM Diagnosis Code E13.65

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.

Convert E13.65 to ICD-9-CM

• ICD-9-CM Code: 249.80 - Sec DM oth nt st uncontr
  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: 250.80 - DMII oth nt st uncntrld
  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 E13.65 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

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Hyperglycemia

What is blood glucose?

Blood glucose, or blood sugar, is the main sugar found in your blood. It is your body's primary source of energy. It comes from the food you eat. Your body breaks down most of that food into glucose and releases it into your bloodstream. When your blood glucose goes up, it signals your pancreas to release insulin. Insulin is a hormone that helps the glucose get into your cells to be used for energy.

For people with diabetes, your body doesn't make enough insulin, can't use it as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells.

What is hyperglycemia?

Hyperglycemia means high blood glucose. It most often affects people who have diabetes. When you have diabetes, your body doesn't make enough insulin or can't use it the right way. Too much glucose stays in your blood and doesn't reach your cells.

What causes hyperglycemia?

A key part of managing diabetes is controlling your blood glucose levels. To do this, you need to follow a diabetes meal plan and get regular physical activity. You might also need to take diabetes medicines. You have to balance all of these to keep your blood glucose at the right levels. But if you eat too much food or the wrong foods, don't take your medicines correctly, or don't get physical activity, you can get hyperglycemia. It can also happen if you are stressed or sick.

Less commonly, people who don't have diabetes can also get hyperglycemia. It can be caused by conditions that can affect insulin or glucose levels in your blood. They include problems with your pancreas or adrenal glands, certain medicines, and severe illnesses.

What are the symptoms of hyperglycemia?

The symptoms of hyperglycemia include:

• Feeling thirsty
• Feeling tired or weak
• Headaches
• Urinating (peeing) often
• Blurred vision

If you are diabetic and you often have high blood glucose levels or the symptoms of hyperglycemia, talk with your health care team. You may need a change in your diabetes meal plan, physical activity plan, or diabetes medicines.

If you don't have diabetes and you are having these symptoms, see your provider to find out the cause and how to treat it.

What other problems can hyperglycemia cause?

If hyperglycemia is not treated, it can cause other problems. In people with diabetes, long-term hyperglycemia can lead to serious health problems (diabetes complications).

If your blood glucose levels get very high, you can develop diabetes-related ketoacidosis (DKA). It happens when your body doesn't have enough insulin to allow blood glucose into your cells for use as energy. Instead, your liver breaks down fat for fuel. This process produces acids called ketones. When too many ketones are produced too fast, they can build up to dangerous levels in your body. This can be life-threatening.

The symptoms of DKA may include:

• Trouble breathing
• Nausea or vomiting
• Pain in your abdomen (belly)
• Confusion
• Feeling very tired or sleepy

If you have an an at-home test for ketones, check your ketone level every 4 to 6 hours when your blood glucose is very high or when you are having these symptoms. If the test shows that your ketones are moderate or high, or if you don't have a ketones test, contact your health care provider right away or get emergency medical help.

How is hyperglycemia diagnosed?

If you have diabetes, you'll most likely need to check your blood glucose every day and make sure that it's not too high. You can do this with a blood glucose meter or continuous glucose monitoring (CGM) system.

There are also blood tests that providers can use to check if your blood glucose is too high.

What are the treatments for hyperglycemia?

If you have diabetes and often have high blood glucose, your health care team may make changes to your diabetes meal plan, physical activity plan, and/or diabetes medicines.

If you have severe hyperglycemia and are having symptoms of DKA, you will need treatment at the hospital. The treatment often includes I.V. (intravenous) fluids and insulin.

Can hyperglycemia be prevented?

If you have diabetes, managing your diabetes can help prevent hyperglycemia. To manage your diabetes, it's important to:

• Follow your diabetes meal plan
• Get regular physical activity
• If you need diabetes medicines, take them correctly
• Regularly check your blood glucose level
• Get regular checkups with your health care team

[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.