2025 ICD-10-CM code E16
This code encompasses various disorders of the pancreas's hormone production, excluding conditions categorized elsewhere. These disorders involve irregular hormone levels affecting functions like digestion and blood sugar control.
Medical necessity must be demonstrated for services related to E16 codes.This involves documenting the signs, symptoms, and diagnostic test results that support the diagnosis of a pancreatic endocrine disorder. The medical record should also justify the treatment plan and explain why it is necessary to address the patient's specific condition.For conditions like hypoglycemia, the severity and frequency of episodes should be documented, along with any related complications.
In simple words: This code represents conditions where your pancreas isn't producing the right amount of certain hormones, which can affect things like how your body digests food and controls blood sugar.
E16 encompasses conditions where the pancreas produces abnormal levels of hormones other than insulin, impacting digestion and blood sugar regulation. Specific subcategories under E16 further classify these disorders by the affected hormone or the resulting condition, such as drug-induced hypoglycemia (E16.0), other hypoglycemia (E16.1), and increased secretion of glucagon (E16.3) or gastrin (E16.4).
Example 1: A patient experiences dizziness, sweating, and confusion after taking a new medication. Blood tests reveal low blood sugar, leading to a diagnosis of drug-induced hypoglycemia, coded as E16.0., A patient with a history of pancreatic tumors experiences recurrent episodes of abdominal pain, diarrhea, and weight loss. Diagnostic tests indicate excessive gastrin secretion, leading to a diagnosis of Zollinger-Ellison syndrome, coded as E16.4., A patient presents with unexplained weight loss, frequent thirst, and increased urination. Laboratory results show elevated blood sugar and high glucagon levels, leading to a diagnosis of increased glucagon secretion, coded as E16.3.
Thorough documentation is crucial for accurate coding, including medical history, physical exam findings, and laboratory test results.Detailed descriptions of symptoms, the duration and frequency of hypoglycemic episodes, imaging studies of the pancreas, and medication lists are important.For drug-induced hypoglycemia, the causal relationship between the medication and the condition should be clearly established. Documentation of hormone levels (e.g., gastrin, glucagon) is necessary for confirming specific diagnoses.
- Specialties:Endocrinology, Gastroenterology, Internal Medicine, Family Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Telehealth Provided in Patient’s Home