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BETA v.3.0

2025 ICD-10-CM code E11

Type 2 diabetes mellitus.It includes diabetes due to insulin secretory defect,diabetes NOS and insulin resistant diabetes.

Code E11 is used for uncomplicated type 2 diabetes. Additional codes should be used to document any complications or associated conditions.

Medical necessity for diabetes treatment is established by the presence of symptoms, elevated blood glucose levels, and the risk of developing complications. Treatment aims to control blood glucose, manage other risk factors, and prevent or delay complications.

Diagnosis and management of type 2 diabetes typically involves primary care physicians, endocrinologists, and other specialists as needed, such as ophthalmologists, nephrologists, and podiatrists. Patient self-management through lifestyle changes (diet, exercise) is crucial.

IMPORTANT:Use additional code to identify control using: insulin (Z79.4), oral antidiabetic drugs (Z79.84). Excludes1: diabetes mellitus due to underlying condition (E08.-), drug or chemical induced diabetes mellitus (E09.-), gestational diabetes (O24.4-), neonatal diabetes mellitus (P70.2), postpancreatectomy diabetes mellitus (E13.-), postprocedural diabetes mellitus (E13.-), secondary diabetes mellitus NEC (E13.-), type 1 diabetes mellitus (E10.-)

In simple words: Type 2 diabetes is a condition where your body has trouble using or making enough insulin, a hormone that helps sugar (glucose) from food get into your cells for energy.This causes sugar to build up in your blood, which can lead to health problems over time if not managed.

Type 2 diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia (high blood sugar) resulting from impaired insulin secretion, insulin resistance, or both. The body either doesn't produce enough insulin or the cells don't respond to it effectively, leading to glucose buildup in the bloodstream.

Example 1: A 50-year-old obese patient presents with increased thirst, frequent urination, and fatigue. Blood tests reveal elevated fasting plasma glucose and HbA1c levels, confirming a diagnosis of type 2 diabetes mellitus., A 65-year-old patient with a long history of poorly controlled type 2 diabetes develops diabetic retinopathy, requiring laser treatment to prevent vision loss., A 40-year-old patient with a family history of type 2 diabetes is diagnosed with prediabetes and begins lifestyle interventions (diet, exercise) to prevent progression to diabetes.

Documentation should include symptoms, physical exam findings, laboratory results (fasting plasma glucose, HbA1c, lipid profile, renal function tests), family history, and other relevant medical history.

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