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ICD-10 Code E11.65 Type 2 Diabetes Mellitus with Hyperglycemia
- E11.9 ICD-10 code identifies Type 2 Diabetes Mellitus without complications.
- It is appropriate for use as a primary diagnosis code.
- If complications are present, coders must assign a more specific ICD-10 code.
- Correct coding ensures accurate reimbursement and compliance with payer policies.
The ICD-10-CM diagnosis code E11.9 is one of the most frequently used diabetes codes in medical billing and clinical documentation. It is assigned when a patient has Type 2 Diabetes Mellitus (T2DM) without documented complications.
This guide covers the description, usage, related codes, and coding best practices to help providers, coders, and billers ensure compliance and accurate reimbursement.
What is Diagnosis Code E11.9?
- Code: E11.9
- Description: Type 2 Diabetes Mellitus without complications
- Category: Endocrine, nutritional, and metabolic diseases (E08–E13 series for diabetes)
- Clinical Meaning: The patient has type 2 diabetes, but there is no evidence of diabetic complications (e.g., nephropathy, neuropathy, retinopathy, or vascular disease).
E11.9 Diagnosis Code Description
The E11.9 ICD-10-CM code applies when:
- The patient has Type 2 Diabetes Mellitus.
- No complications are noted in the patient’s medical record.
- No other more specific diabetes codes apply.
It is often used as a primary diagnosis code in billing, especially for office visits focused on diabetes management and monitoring without complication management.
Symptoms Associated with E11.65
Patients with Type 2 diabetes and hyperglycemia may exhibit the following symptoms:
- Frequent urination
- Increased thirst
- Fatigue
- Blurred vision
- High blood sugar levels (documented via glucose meters)
- Headaches
Related ICD-10 Codes for Diabetes
While E11.9 covers uncomplicated type 2 diabetes, more specific ICD-10 codes exist for diabetes with complications, including:
- E11.65 – Type 2 diabetes mellitus with hyperglycemia
- E11.21 – Type 2 diabetes mellitus with diabetic nephropathy
- E11.319 – Type 2 diabetes mellitus with unspecified diabetic retinopathy
- E11.40 – Type 2 diabetes mellitus with diabetic neuropathy, unspecified
- E11.51 – Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
When Should E11.9 Be Used?
- For patients with documented type 2 diabetes and no complications.
- When diabetes management involves routine care such as medication adjustment, lifestyle counseling, and lab monitoring.
- When the provider has not documented complications or when records do not support assignment of a more specific code.
When NOT to Use E11.9
- If the patient has documented complications (use E11.2–E11.6 series).
- For Type 1 Diabetes Mellitus – use E10.x codes.
- For diabetes secondary to another condition or drug – use E08 or E09 codes.
Common Scenarios for E11.9 Usage
- Routine follow-up visits for type 2 diabetes management
- Prescription refills for oral hypoglycemic medications or insulin
- Lab monitoring such as HbA1c testing without evidence of complications
- Preventive counseling related to diet, exercise, and glucose monitoring
Conclusion
The E11.9 ICD-10 diagnosis code plays a central role in documenting and billing type 2 diabetes care when no complications are involved. Using this code correctly helps healthcare providers streamline revenue cycle management, prevent denials, and maintain compliance with payer requirements.
Express Medical Billing, experts specialize in diabetes coding and billing accuracy. From selecting the right ICD-10 codes to optimizing claim submission, we help providers reduce denials and get reimbursed faster.
Frequently Asked Questions (FAQs)
Yes. E11.9 is commonly used as a primary diagnosis code when a patient is being seen for type 2 diabetes without complications.
- E11.9: Type 2 diabetes without complications.
- E11.90: Type 2 diabetes without complications, unspecified (used when the record does not clearly state details about complications).
It means the patient has type 2 diabetes but does not currently have kidney, eye, nerve, or circulatory complications.
Yes. E11.9 is a billable and valid ICD-10 code for reimbursement purposes.
Yes. E11.9 can be paired with Z-codes (such as Z79.4 for long-term insulin use or Z79.84 for oral hypoglycemic use) to give payers a more complete clinical picture.
