2024 ICD-10-CM Diagnosis Code E11.621

Approximate Synonyms

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

• Chronic neurogenic ulcer of lower limb
• Chronic ulcer of left foot
• Chronic ulcer of left foot due to diabetes mellitus
• Chronic ulcer of right foot
• Chronic ulcer of right foot due to diabetes mellitus
• Diabetic foot
• Foot ulcer due to type 2 diabetes mellitus
• Ischemic ulcer of foot due to diabetes mellitus
• Ischemic ulcer of foot due to type 2 diabetes mellitus
• Mixed diabetic ulcer - foot
• Neuroischemic foot ulcer
• Neuropathic ulcer of foot due to diabetes mellitus
• Neuropathic ulcer of foot due to diabetes mellitus
• Neuropathic ulcer of foot due to diabetes mellitus
• Neuropathic ulcer of foot due to diabetes mellitus
• Neuropathic ulcer of foot due to diabetes mellitus
• Neuropathic ulcer of foot due to type 2 diabetes mellitus
• Neuropathic ulcer of foot due to type 2 diabetes mellitus
• Neuropathic ulcer of foot due to type 2 diabetes mellitus
• Neuropathic ulcer of heel due to type 2 diabetes mellitus
• Neuropathic ulcer of midfoot due to type 2 diabetes mellitus
• Neuropathic ulcer of toe due to type 2 diabetes mellitus
• Skin ulcer due to type 2 diabetes mellitus
• Skin ulcer due to type 2 diabetes mellitus
• Skin ulcer due to type 2 diabetes mellitus
• Skin ulcer due to type 2 diabetes mellitus
• Skin ulcer due to type 2 diabetes mellitus
• Skin ulcer of toe due to diabetes mellitus type 2
• Ulcer of forefoot due to type 2 diabetes mellitus
• Ulcer of heel due to diabetes mellitus
• Ulcer of heel due to type 2 diabetes mellitus
• Ulcer of left foot due to diabetes mellitus
• Ulcer of left foot due to type 2 diabetes mellitus
• Ulcer of midfoot due to diabetes mellitus
• Ulcer of right foot due to diabetes mellitus
• Ulcer of right foot due to type 2 diabetes mellitus
• Ulcer of toe due to type 2 diabetes mellitus
• Ulcer of toe due to type 2 diabetes mellitus

Clinical Information

• Diabetic Foot

  common foot problems in persons with diabetes mellitus, caused by any combination of factors such as diabetic neuropathies; peripheral vascular diseases; and infection. with the loss of sensation and poor circulation, injuries and infections often lead to severe foot ulceration, gangrene and amputation, surgical.

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.

If the type of diabetes mellitus is not documented in the medical record the default is E11.-, Type 2 diabetes mellitus.

Convert E11.621 to ICD-9-CM

• 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 E11.621 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 Type 2

What is type 2 diabetes?

Type 2 diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your main source of energy. It comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. If you have diabetes, your body doesn't make enough insulin or doesn't use insulin well. The glucose then stays in your blood and not enough goes into your cells.

Over time, having too much glucose in your blood can cause health problems. But you can take steps to manage your diabetes and try to prevent these health problems.

What causes type 2 diabetes?

Type 2 diabetes may be caused by a combination of factors:

• Being overweight or having obesity
• Not being physically active
• Genetics and family history

Type 2 diabetes usually starts with insulin resistance. This is a condition in which your cells don't respond normally to insulin. As a result, your body needs more insulin to help the glucose enter your cells. At first, your body makes more insulin to try to get cells to respond. But over time, your body can't make enough insulin, and your blood glucose levels rise.

Who is at risk for type 2 diabetes?

You are at higher risk of developing type 2 diabetes if you:

• Are over age 45. Children, teenagers, and younger adults can get type 2 diabetes, but it is more common in middle-aged and older people.
• Have prediabetes, which means that your blood sugar is higher than normal but not high enough to be called diabetes
• Had diabetes in pregnancy or gave birth to a baby weighing 9 pounds or more.
• Have a family history of diabetes
• Are overweight or have obesity
• Are Black or African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
• Are not physically active
• Have other conditions such as high blood pressure, heart disease, stroke, polycystic ovary syndrome (PCOS), or depression
• Have low HDL (good) cholesterol and high triglycerides
• Have acanthosis nigricans - dark, thick, and velvety skin around your neck or armpits

What are the symptoms of type 2 diabetes?

Many people with type 2 diabetes have no symptoms at all. If you do have them, the symptoms develop slowly over several years. They might be so mild that you do not notice them. The symptoms can include:

• Increased thirst and urination
• Increased hunger
• Feeling tired
• Blurred vision
• Numbness or tingling in the feet or hands
• Sores that do not heal
• Unexplained weight loss

How is type 2 diabetes diagnosed?

Your health care provider will use blood tests to diagnose type 2 diabetes. The blood tests include:

• A1C test, which measures your average blood sugar level over the past 3 months
• Fasting plasma glucose (FPG) test, which measures your current blood sugar level. You need to fast (not eat or drink anything except water) for at least 8 hours before the test.
• Random plasma glucose (RPG) test, which measures your current blood sugar level. This test is used when you have diabetes symptoms and the provider does not want to wait for you to fast before having the test.

What are the treatments for type 2 diabetes?

Treatment for type 2 diabetes involves managing your blood sugar levels. Many people are able to do this by living a healthy lifestyle. Some people may also need to take medicine.:

• A healthy lifestyle includes following a healthy eating plan and getting regular physical activity. You need to learn how to balance what you eat and drink with physical activity and diabetes medicine, if you take any.
• Medicines for diabetes include oral medicines, insulin, and other injectable medicines. Over time, some people will need to take more than one type of medicine to control their diabetes.
• You will need to check your blood sugar regularly. Your health care provider will tell you how often you need to do it.
• It's also important to keep your blood pressure and cholesterol levels close to the targets your provider sets for you. Make sure to get your screening tests regularly.

Can type 2 diabetes be prevented?

You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

[Learn More in MedlinePlus]

Diabetic Foot

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose can't get into your cells as quickly as usual. The glucose builds up in your blood and causes high blood sugar levels.

How does diabetes cause foot problems?

Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in your feet.

If you can't feel pain, you may not know when you have a cut, blister, or ulcer (open sore) on your foot. A wound like that could get infected. The infection may not heal well because the damaged blood vessels can cause poor blood flow in your feet.

Having an infection and poor blood flow can lead to gangrene. That means the muscle, skin, and other tissues start to die. If you have gangrene or a foot ulcer that does not get better with treatment, you may need an amputation. This is a surgery to cut off your damaged toe, foot, or part of your leg. It may prevent a bad infection from spreading and could save your life.

But there's a lot you can do to prevent a foot wound from becoming a major health problem.

How can I protect my feet if I have diabetes?

The best way to protect your feet is by controlling your blood sugar levels every day. This will help keep nerve and blood vessel damage from getting worse. The next step is to keep the skin of your feet healthy.

Good foot care for people with diabetes includes:

• Checking your feet every day. Look for cuts, redness, and other changes in the skin and toenails, including warts or other spots that your shoes could rub. Make sure to check the bottoms of your feet too.
• Washing your feet every day. Use warm water and soap. Don't soak your feet because that can dry out your skin. After you dry your feet, you can use talcum powder or cornstarch between your toes. They soak up moisture that can cause infection. If you use lotion, don't apply it between your toes.
• Asking your doctor how to remove corns and calluses safely. Thick skin on your feet can rub and lead to sores. But removing it the wrong way could damage your skin. So you don't want to cut the skin or use medicated pads or liquid removers.
• Trimming your toenails straight across with a clipper. If it's hard for you to trim your own toenails, or if they're thick or curve into the skin, have a podiatrist (foot doctor) do it for you.
• Always wearing well-fitting shoes and socks or slippers to protect your feet when walking. You don't want to walk barefoot, even indoors. And be sure your shoes are smooth inside. A seam or pebble could rub your skin raw.
• Protecting your feet from heat and cold. Use sunscreen on exposed skin and don't walk barefoot at the beach. In cold weather, wear warm socks instead of warming your feet near a heater or fireplace.
• Keeping the blood flowing in your feet. Put your feet up when you're sitting. Wiggle your toes and circle your feet throughout the day. Don't wear tight socks. And get plenty of activity that's not too hard on the feet, such as walking.
• Getting your feet checked at your health care visits. Even if you haven't noticed a problem, it's good to have your health care provider look at your feet.

When should I see my health care provider about diabetic foot problems?

Serious foot problems can develop quickly. See your health care provider right away if you notice:

• A cut, blister, or bruise on your feet that doesn't start to heal in a few days
• Red, warm, or painful skin on your feet
• A callus with dried blood inside
• A foot infection that becomes black and smells bad that could be gangrene

Remember, controlling your blood sugar and caring for your feet every day are the best steps you can take to prevent serious diabetic foot problems.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

[Learn More in MedlinePlus]

Type 2 diabetes

Type 2 diabetes is a disorder characterized by abnormally high levels of blood glucose, also called blood sugar. In this form of diabetes, the body stops using and making insulin properly. Insulin is a hormone produced in the pancreas that helps regulate blood glucose levels. Specifically, insulin controls how much glucose (a type of sugar) is passed from the blood into cells, where it is used as an energy source. When blood glucose levels are high (such as after a meal), the pancreas releases insulin to move the excess glucose into cells, which reduces the amount of glucose in the blood.

Most people who develop type 2 diabetes first have insulin resistance, a condition in which the body's cells use insulin less efficiently than normal. As insulin resistance develops, more and more insulin is needed to keep blood glucose levels in the normal range. To keep up with the increasing need, insulin-producing cells in the pancreas (called beta cells) make larger amounts of insulin. Over time, the beta cells become less able to respond to blood glucose changes, leading to an insulin shortage that prevents the body from reducing blood glucose levels effectively. Most people have some insulin resistance as they age, but inadequate exercise and excessive weight gain make it worse, greatly increasing the likelihood of developing type 2 diabetes.

Type 2 diabetes can occur at any age, but it most commonly begins in middle age or later. Signs and symptoms develop slowly over years. They include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, tingling or loss of feeling in the hands and feet (diabetic neuropathy), sores that do not heal well, and weight loss. If blood glucose levels are not controlled through medication or diet, type 2 diabetes can cause long-lasting (chronic) health problems including heart disease and stroke; nerve damage; and damage to the kidneys, eyes, and other parts of the body.

[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.