2024 ICD-10-CM Diagnosis Code E16.1

Approximate Synonyms

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

• Alimentary hyperinsulinemia
• Alimentary hypoglycemia
• Autoimmune hypoglycemia
• Autosomal dominant hyperinsulinism due to Kir6.2 deficiency
• Autosomal dominant hyperinsulinism due to SUR1 deficiency
• Autosomal recessive hyperinsulinism due to Kir6.2 deficiency
• Autosomal recessive hyperinsulinism due to SUR1 deficiency
• Diazoxide-resistant focal hyperinsulinism due to Kir6.2 deficiency
• Diazoxide-resistant focal hyperinsulinism due to SUR1 deficiency
• Ectopic hyperinsulinism
• Ectopic IGF hypoglycemia
• Ectopic IGF-1 hypoglycemia
• Ectopic IGF-2 hypoglycemia
• Endocrine system complication of procedure
• Exercise-induced hyperinsulinism
• Fasting hypoglycemia
• Functional hyperinsulinism
• Hyperammonemia
• Hyperglycemia due to diabetes mellitus
• Hyperinsulinemia due to benign insulinoma
• Hyperinsulinemia due to malignant insulinoma
• Hyperinsulinism
• Hyperinsulinism and hyperammonemia syndrome
• Hyperinsulinism due to deficiency of glucokinase
• Hyperinsulinism due to focal adenomatous hyperplasia
• Hyperinsulinism due to HNF1A deficiency
• Hyperinsulinism due to HNF4A deficiency
• Hyperinsulinism due to insulin receptor deficiency
• Hyperinsulinism due to short chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency
• Hyperinsulinism due to uncoupling protein 2 deficiency
• Hyperplasia of pancreatic islet beta cell
• Hypoglycemia
• Hypoglycemia of childhood
• Iatrogenic hyperinsulinism
• Idiopathic postprandial hypoglycemia
• Impaired glucose tolerance with hyperinsulism
• Islet cell hyperplasia
• Islet cell hyperplasia
• Ketotic hypoglycemia
• Metabolic complication of procedures
• Metabolic complication of procedures
• Mixed hypoglycemia
• Neuroglycopenia
• Non-diabetic disorder of endocrine pancreas
• Non-diabetic hypoglycemia
• Non-diabetic hypoglycemia
• Non-diabetic hypoglycemia
• Non-diabetic hypoglycemia
• Non-diabetic hypoglycemia
• Post gastrointestinal tract surgery hypoglycemia
• Post gastrointestinal tract surgery hypoglycemia
• Post-prandial hypoglycemia
• Reactive hypoglycemia
• Recurrent severe hypoglycemia
• Somogyi phenomenon
• Tumor-induced hypoglycemia

Clinical Information

• Congenital Hyperinsulinism

  a familial, nontransient hypoglycemia with defects in negative feedback of glucose-regulated insulin release. clinical phenotypes include hypoglycemia; hyperinsulinemia; seizures; coma; and often large birth weight. several sub-types exist with the most common, type 1, associated with mutations on an atp-binding cassette transporters (subfamily c, member 8).

• Hypoglycemia

  a syndrome of abnormally low blood glucose level. clinical hypoglycemia has diverse etiologies. severe hypoglycemia eventually lead to glucose deprivation of the central nervous system resulting in hunger; sweating; paresthesia; impaired mental function; seizures; coma; and even death.

• Hyperinsulinism

  a syndrome with excessively high insulin levels in the blood. it may cause hypoglycemia. etiology of hyperinsulinism varies, including hypersecretion of a beta cell tumor (insulinoma); autoantibodies against insulin (insulin antibodies); defective insulin receptor (insulin resistance); or overuse of exogenous insulin or hypoglycemic agents.

• Nesidioblastosis

  an inherited autosomal recessive syndrome characterized by the disorganized formation of new islets in the pancreas and congenital hyperinsulinism. it is due to focal hyperplasia of pancreatic islet cells budding off from the ductal structures and forming new islets of langerhans. mutations in the islet cells involve the potassium channel gene kcnj11 or the atp-binding cassette transporter gene abcc8, both on chromosome 11.

• Carbamoyl-Phosphate Synthase I Deficiency Disease

  a urea cycle disorder manifesting in infancy as lethargy, emesis, seizures, alterations of muscle tone, abnormal eye movements, and an elevation of serum ammonia. the disorder is caused by a reduction in the activity of hepatic mitochondrial carbamoyl-phosphate synthase (ammonia). (menkes, textbook of child neurology, 5th ed, pp50-1)

• Hyperammonemia

  elevated level of ammonia in the blood. it is a sign of defective catabolism of amino acids or ammonia to urea.

• Hyperlysinemias

  a group of inherited metabolic disorders which have in common elevations of serum lysine levels. enzyme deficiencies of alpha-aminoadipic semialdehyde dehydrogenase and the saccharopine dehydrogenases have been associated with hyperlysinemia. clinical manifestations include mental retardation, recurrent emesis, hypotonia, lethargy, diarrhea, and developmental delay. (from menkes, textbook of child neurology, 5th ed, p56)

• Rett Syndrome

  an inherited neurological developmental disorder that is associated with x-linked inheritance and may be lethal in utero to hemizygous males. the affected female is normal until the age of 6-25 months when progressive loss of voluntary control of hand movements and communication skills; ataxia; seizures; autistic behavior; intermittent hyperventilation; and hyperammonemia appear. (from menkes, textbook of child neurology, 5th ed, p199)

• Idiopathic Ketotic Hypoglycemia|Accelerated Starvation

  ketotic hypoglycemia that usually occurs in young, thin children in association with infection or fasting, and which typically resolves by age 6-8 years.

• Ketotic Hypoglycemia

  a condition in which hypoglycemia is accompanied by ketosis. this condition may be a manifestation of another condition such as glycogen storage disease, ketone utilization defects, growth hormone deficiency, or cortisol deficiency.

E16.1 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert E16.1 to ICD-9-CM

• ICD-9-CM Code: 251.1 - Oth spcf hypoglycemia
  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.

Patient Education

Congenital hyperinsulinism

Congenital hyperinsulinism is a condition that causes individuals to have abnormally high levels of insulin. Insulin is a hormone that helps control levels of blood glucose, also called blood sugar. People with this condition have frequent episodes of low blood glucose (hypoglycemia). In infants and young children, these episodes are characterized by a lack of energy (lethargy), irritability, or difficulty feeding. Repeated episodes of low blood glucose increase the risk for serious complications such as breathing difficulties, seizures, intellectual disability, vision loss, brain damage, and coma.

The severity of congenital hyperinsulinism varies widely among affected individuals, even among members of the same family. About 60 percent of infants with this condition experience a hypoglycemic episode within the first month of life. Other affected children develop hypoglycemia by early childhood. Unlike typical episodes of hypoglycemia, which occur most often after periods without food (fasting) or after exercising, episodes of hypoglycemia in people with congenital hyperinsulinism can also occur after eating.

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.