Valid for Submission
E13.9 is a billable diagnosis code used to specify a medical diagnosis of other specified diabetes mellitus without complications. The code E13.9 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code E13.9 might also be used to specify conditions or terms like 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, etc.
The code E13.9 is not usually sufficient justification for admission to an acute care hospital when used as a principal diagnosis.
The code E13.9 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 E13.9 are found in the index:
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
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
- 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
- Pancreatic hypoplasia, diabetes mellitus, congenital heart disease syndrome
- Permanent neonatal diabetes mellitus
- Permanent neonatal diabetes mellitus with cerebellar agenesis syndrome
- Primary microcephaly, mild intellectual disability, young-onset diabetes syndrome
- Secondary diabetes mellitus
- Secondary endocrine diabetes mellitus
Convert E13.9 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code E13.9 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 E13.9 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, 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
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.
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