ICD Code E11.21

ICD code E11.21 is type 2 diabetes mellitus with diabetic nephropathy, indicating a patient has type 2 diabetes and kidney disease caused by diabetes.

1. Patient has a confirmed diagnosis of type 2 diabetes mellitus.

2. Evidence of diabetic nephropathy, such as persistent albuminuria, reduced glomerular filtration rate (GFR), or other clinical/laboratory findings indicating kidney involvement due to diabetes.

3. Absence of other primary causes of nephropathy unrelated to diabetes.

4. Documentation of both diabetes and nephropathy in the patient’s medical record.

5. Symptoms may include proteinuria, edema, hypertension, or declining renal function in the context of diabetes.

Relevant CPT codes that may be used to treat ICD code E11.21 include:

- 99202–99215 (Evaluation and Management services)

- 82947 (Glucose; quantitative, blood [except reagent strip])

- 83036 (Hemoglobin; glycosylated [A1C])

- 81000–81003 (Urinalysis)

- 84132 (Potassium; serum)

- 82565 (Creatinine; blood)

- 82043 (Microalbumin, urine)

- 36415 (Collection of venous blood by venipuncture)

- 90935, 90937, 90945, 90947 (Hemodialysis procedures, if indicated)

- 99217–99220, 99221–99223 (Hospital observation or inpatient care, if applicable)

CPT code selection should be based on the specific services rendered for ICD code E11.21.

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