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

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

3. 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.

4. 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.

5. Endocrine System
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6. 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.

7. 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

8. 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.

9. 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

10. 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.

11. 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.

12. 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

13. 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

14. 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

15. 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

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

17. 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

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

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