Navigating the complexities of medical diagnosis codes is crucial for healthcare professionals, especially when dealing with chronic conditions like diabetes. ICD-10-CM code E11.42, specifically, is designated for Type 2 diabetes mellitus with diabetic polyneuropathy. This code is more than just a label; it’s a key for accurate diagnosis, treatment planning, and insurance billing. Let’s delve into what E11.42 entails and why it’s important in the medical field.
What is E11.42?
E11.42 is a specific, billable diagnosis code within the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). This code officially came into effect on October 1, 2015, and the current version, 2025 ICD-10-CM E11.42, is valid from October 1, 2024. It’s important to note that E11.42 is the United States’ version of this code; international versions may have variations. This code is used to classify cases where a patient has been diagnosed with type 2 diabetes mellitus and also suffers from diabetic polyneuropathy.
Diabetic polyneuropathy itself is a significant complication of diabetes, characterized by nerve damage resulting from prolonged high blood sugar levels. This condition affects multiple peripheral nerves, often leading to symptoms like pain, numbness, and weakness, typically in the hands and feet. The inclusion of “diabetic neuralgia” under E11.42 indicates that nerve pain associated with diabetes is also categorized under this code.
Synonyms and Related Terms for E11.42
To ensure clarity and accuracy in medical records and communication, several terms are considered synonymous with E11.42. These include:
- Diabetes type 2 with diabetic polyneuropathy
- Diabetes type 2 with peripheral neuropathy
- Diabetic peripheral neuropathy associated with type 2 diabetes mellitus
- Diabetic polyneuropathy
- Polyneuropathy (disorder of multiple nerves) diabetic
- Polyneuropathy (multiple nerve disorder), diabetic
- Polyneuropathy associated with type 2 diabetes mellitus
- Polyneuropathy associated with type ii diabetes mellitus
- Polyneuropathy due to type 2 diabetes mellitus
Understanding these synonyms helps healthcare providers and coders accurately identify and apply the E11.42 code in various clinical scenarios and documentation.
Coding History and Context of E11.42
The code E11.42 was introduced in 2016 as a new code when the non-draft ICD-10-CM became effective. Since its inception, there have been no changes to the code through the 2025 edition, maintaining its definition and application consistently over the years. E11.42 falls under the broader category of E11.4, which encompasses “Type 2 diabetes mellitus with neurological complications.” Within this category, E11.42 is more specific than E11.40 (“Type 2 diabetes mellitus with diabetic neuropathy, unspecified”) and E11.41 (“Type 2 diabetes mellitus with diabetic mononeuropathy”), pinpointing the condition as polyneuropathy.
This level of specificity is essential for medical coding and statistical tracking. It allows for a more nuanced understanding of diabetic complications and helps in resource allocation, research, and public health initiatives related to diabetes and its neurological impacts.
Conclusion
The E11.42 Diagnosis Code is a vital tool in classifying and understanding the co-occurrence of type 2 diabetes mellitus and diabetic polyneuropathy. Its specific nature ensures accurate medical documentation, facilitates appropriate reimbursement, and contributes to comprehensive data collection on diabetes-related complications. For professionals in medical billing, coding, and healthcare, a thorough understanding of E11.42 is indispensable for effective practice and patient care.
