2025 ICD-10-CM code E08
(Active) Effective Date: N/A Endocrine, Nutritional and Metabolic Diseases - Diabetes mellitus due to underlying condition 4 Feed
Diabetes mellitus due to an underlying condition. Code first the underlying condition.
The medical necessity for the E08 code hinges on demonstrating the causal relationship between the underlying condition and the development of diabetes. This might involve documentation of abnormal pancreatic function testing, imaging studies, or other relevant diagnostic criteria.
The provider diagnoses the disease based on history, physical examination, and signs and symptoms. Laboratory tests include blood tests for fasting plasma glucose, lipid profile, stool examination, and plain X-ray and ultrasound of the abdomen to detect pancreatic calcification. Treatment depends on the underlying cause of the disease. Corticosteroids, radiation therapy, chemotherapy, antibiotics, and sometimes surgery are used to treat the underlying condition; however, diabetes mellitus is treated with noninsulin and insulin therapies, depending upon the type and glucose levels in the blood.
In simple words: This code represents diabetes that is caused by another medical problem.Your doctor will also record the code for the underlying cause, which could be anything from cystic fibrosis to cancer.
Diabetes mellitus due to underlying condition. This code is used for diabetes resulting from conditions such as cystic fibrosis, malignant neoplasm, malnutrition, pancreatitis, and Cushing's syndrome. Code first the underlying condition, such as: congenital rubella (P35.0), Cushing's syndrome (E24.-), cystic fibrosis (E84.-), malignant neoplasm (C00-C96), malnutrition (E40-E46), pancreatitis and other diseases of the pancreas (K85-K86.-). Use additional code to identify control using: insulin (Z79.4), oral antidiabetic drugs (Z79.84), oral hypoglycemic drugs (Z79.84).
Example 1: A patient with a long-standing history of chronic pancreatitis (K86.1) presents with elevated blood glucose levels and symptoms consistent with diabetes. E08 is used, followed by K86.1., A patient undergoing chemotherapy for pancreatic cancer (C25.9) develops new-onset diabetes. E08 is used, followed by C25.9., A child with cystic fibrosis (E84.0) develops diabetes. Code E08 is used first, and then E84.0.
Documentation should clearly identify the underlying condition causing the diabetes, the type of diabetes, and any associated complications.Lab results supporting the diagnosis of diabetes should also be included. It is important to differentiate between type 1, type 2, and secondary diabetes due to underlying conditions. The documentation must support the link between the underlying condition and the diabetes.
** It is crucial to distinguish between E08 (diabetes due to underlying condition) and other diabetes codes like E10 (Type 1) and E11 (Type 2). Using the correct code ensures proper reimbursement and accurate reflection of the patient's health status.
- Payment Status: Active
- Specialties:Endocrinology, Internal Medicine, Family Medicine, Pediatrics (depending on the underlying condition)
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, and other places of service depending on the clinical scenario.