ICD Code E13.10

ICD code E13.10 is other specified diabetes mellitus with ketoacidosis, but without coma.

1. Patient has a diagnosis of diabetes mellitus that is not classified as type 1 or type 2 (other specified diabetes).

2. Evidence of diabetic ketoacidosis (DKA), including laboratory findings such as elevated blood glucose, presence of ketones in blood or urine, and metabolic acidosis.

3. Absence of coma; patient is alert or has altered mental status not meeting criteria for coma.

4. Clinical presentation may include symptoms such as nausea, vomiting, abdominal pain, dehydration, rapid breathing (Kussmaul respirations), and fruity-scented breath.

5. Exclusion of other causes of ketoacidosis and confirmation that the ketoacidosis is due to the underlying diabetes mellitus.

Relevant CPT codes that may be used to treat ICD code E13.10 include:

- 99221–99223 (Initial hospital care, per day, for the evaluation and management of a patient)

- 99231–99233 (Subsequent hospital care, per day, for the evaluation and management of a patient)

- 82948 (Glucose; blood, reagent strip)

- 82962 (Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use)

- 83036 (Hemoglobin; glycosylated [A1C])

- 36415 (Collection of venous blood by venipuncture)

- 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour)

- 96366 (Each additional hour, intravenous infusion)

- 96372 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular)

- 96374 (Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance/drug)

CPT code selection should be based on the specific services rendered and clinical documentation.

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