Mary Jo Bowie MS, BS, AAS, RHIA, RHIT

Endocrine, Nutritional, and Metabolic Diseases CHAPTER 9 Endocrine, Nutritional, and Metabolic Diseases

Endocrine, Nutritional, and Metabolic Diseases—Code Range E00-E89 Endocrine, Nutritional, and Metabolic Diseases are reported from Chapter 4 of ICD-10-CM. This chapter contains codes for diseases that affect the endocrine system as well as nutritional and metabolic diseases.

Endocrine System The endocrine system consists of several internal groups of glands and structures that produce or secrete hormones. Hormones are chemical substances produced by the body to keep organs and tissues functioning properly.

Endocrine System © Cengage Learning 2014

Coding from Chapter 4 of ICD-10-CM Before coding from this chapter, the coder should reference the instructional notations that appear at the start of the chapter. Code selection should be guided by the notations.

Disorders of the Thyroid Gland—E00-E07 This code block reports disorders of the thyroid gland. The thyroid gland regulates the body’s metabolism. Disorders coded to this section include: Goiters Hypothyroidism Hyperthyroidism Thyroiditis

Diabetes Mellitus—E08-E13 Diabetes mellitus is a complex metabolic disease characterized by hyperglycemia caused by defects in insulin secretion, insulin action, or both. ICD-10-CM identifies the various types of diabetes.

Category Codes for Diabetes Mellitus The category codes for diabetes are: E08—Diabetes mellitus due to underlying condition E09—Drug- or chemical-induced diabetes mellitus E10—Type 1 diabetes mellitus E11—Type 2 diabetes mellitus E13—Other specified diabetes mellitus

Types of Diabetes Type 1 diabetes is also known as juvenile diabetes, juvenile onset, or ketosis-prone diabetes. Type 2 diabetes is also known as adult onset diabetes.

Diabetes Codes The diabetes mellitus codes are combination codes that include the type of diabetes mellitus, the body system affected, and the complications affecting the body system. Coders must review the medical documentation to determine this information.

Other Disorders of Glucose Regulation and Pancreatic Internal Secretion—E15-E16 This block of codes reports: Nondiabetic hypoglycemic coma—E15 Other disorders of pancreatic internal secretion—E16

Disorders of Other Endocrine Glands—E20-E35 Categories found in this section report: Hypoparathyroidism Hyperparathyroidism Hyperfunction of pituitary gland Cushing’s syndrome Adrenogenital disorders Ovarian dysfunction Testicular dysfunction And other conditions

Intraoperative Complications of Endocrine System—E36 This category reports: Intraoperative hemorrhage and hematoma of an endocrine system organ or structure complicating a procedure Accidental puncture and laceration of an endocrine system organ or structure during a procedure Other intraoperative complications of the endocrine system

Malnutrition—E40-E46 These categories report the following: Kwashiorkor—E40 Nutritional marasmus—E41 Marasmic kwashiorkor—E42 Unspecified severe protein-calorie malnutrition—E43 Protein-calorie malnutrition of moderate and mild degree—E44 Retarded development following protein-calorie malnutrition—E45 Unspecified protein-calorie malnutrition—E 46

Remaining Categories Other nutritional deficiencies—E50-E64 Overweight, obesity, and other hyperalimentation—E65-E68 Metabolic disorders—E70-E89

Official Coding Guidelines for Coding and Reporting The guidelines give direction on the following: Type of diabetes Type of diabetes not documented Diabetes mellitus and the use of insulin Diabetes mellitus in pregnancy and gestational diabetes Complications due to insulin pump malfunction Secondary diabetes

Coding Practice Select the correct code for: Type 2 diabetes with periodontal disease

Coding Practice Solution Main term to reference in index: Diabetes Modifying term: Type 2, then with periodontal disease Code Assignment: E11.630