Understanding diagnosis codes is crucial in healthcare, especially when dealing with conditions like diabetes. Diagnosis code E11.65 specifically refers to Type 2 diabetes mellitus with hyperglycemia within the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). This code is essential for medical billing, record-keeping, and accurately classifying patient conditions.
E11.65 is a billable and specific code, meaning it’s recognized for reimbursement purposes by insurance companies and provides a precise classification of a patient’s diagnosis. The code became effective on October 1, 2015, and the current version is valid for the fiscal year 2025, starting October 1, 2024. This indicates its consistent and ongoing use in the medical field for diagnosing and classifying cases of type 2 diabetes accompanied by hyperglycemia.
What does “Type 2 diabetes mellitus with hyperglycemia” mean?
- Type 2 Diabetes Mellitus: This is a chronic condition affecting the way the body metabolizes glucose (sugar). With type 2 diabetes, the body either resists the effects of insulin — a hormone that regulates sugar’s movement into your cells — or doesn’t produce enough insulin to maintain a normal glucose level.
- Hyperglycemia: This term refers to high blood sugar. It occurs when there’s too much glucose circulating in the blood. In the context of E11.65, it signifies that the patient with type 2 diabetes is experiencing elevated blood sugar levels.
Synonyms for Diagnosis Code E11.65
To further clarify, E11.65 is also known by the following terms:
- Diabetes type 2 with hyperglycemia
- Hyperglycemia due to type 2 diabetes mellitus
These synonyms help healthcare professionals and coders ensure they are correctly identifying and using the diagnosis code E11.65 when documenting patient conditions.
Code History and Context
The code E11.65 has been consistently part of the ICD-10-CM system since 2016, with no changes through the 2025 edition. This stability is important for consistent data collection and analysis over time.
It’s also important to note that E11.65 falls under a broader category of ICD-10-CM codes, specifically within the range related to Type 2 diabetes mellitus with complications. Codes adjacent to E11.65 provide further specificity regarding other complications associated with type 2 diabetes, such as:
- E11.64: Type 2 diabetes mellitus with hypoglycemia (low blood sugar)
- E11.69: Type 2 diabetes mellitus with other specified complication
- E11.8: Type 2 diabetes mellitus with unspecified complications
- E11.9: Type 2 diabetes mellitus without complications
Understanding the context of E11.65 within these related codes helps in accurate diagnosis coding and comprehensive patient care. For those needing to convert this code to the older ICD-9-CM system, conversion tools are available to ensure accurate historical data comparisons when necessary.
In conclusion, diagnosis code E11.65 is a vital tool for classifying and billing for cases of Type 2 diabetes mellitus with hyperglycemia. Its specific nature and consistent use in the ICD-10-CM system ensure accurate medical records and proper reimbursement in healthcare settings.
