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R81
ICD-10-CM
Glucosuria

Understand glucosuria diagnosis, symptoms, and treatment. Find information on glucose in urine, renal glucosuria, diabetes mellitus, and gestational diabetes. Learn about medical coding for glucosuria, including ICD-10 codes and clinical documentation improvement for accurate diagnosis reporting. Explore lab tests, blood glucose levels, urine glucose tests, and the role of healthcare professionals in managing glucosuria.

Also known as

Glycosuria
Renal Glucosuria

Diagnosis Snapshot

Key Facts
  • Definition : Glucose in urine, often indicating high blood sugar.
  • Clinical Signs : Frequent urination, excessive thirst, unexplained weight loss, fatigue.
  • Common Settings : Diabetes (type 1, type 2, gestational), kidney disease, pregnancy.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC R81 Coding
R81

Glycosuria

Presence of glucose in the urine.

E08-E13

Diabetes mellitus

A group of metabolic disorders characterized by hyperglycemia.

O24

Diabetes mellitus in pregnancy

Gestational or pre-existing diabetes complicating pregnancy.

R73.9

Abnormal glucose

Unspecified abnormality of glucose level.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the glucosuria due to diabetes mellitus?

  • Yes

    Type 1 diabetes?

  • No

    Is it renal glucosuria?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Glucose in urine
Diabetes mellitus
Renal glycosuria

Documentation Best Practices

Documentation Checklist
  • Document glucose presence/level in urine
  • Specify testing method used (e.g., dipstick, lab)
  • Correlate with blood glucose levels
  • Document any related symptoms (e.g., polyuria, polydipsia)
  • Note any contributing factors (e.g., diabetes, medications)

Coding and Audit Risks

Common Risks
  • Unspecified Glucosuria

    Coding glucosuria without specifying the cause (e.g., diabetes, renal glucosuria) leads to inaccurate reporting and potential claim denials. Use specific ICD-10 codes.

  • Gestational Diabetes Coding

    Miscoding glucosuria in pregnancy. Differentiate between gestational diabetes (O24.4-) and pre-existing diabetes complicating pregnancy (E09-E13 with O24.0-).

  • Glucosuria Documentation

    Insufficient documentation of glucosuria findings (e.g., type, severity, associated conditions) hinders accurate coding and CDI efforts. Ensure thorough clinical notes.

Mitigation Tips

Best Practices
  • ICD-10 R81, accurate coding for glucosuria diagnosis.
  • Document glucosuria cause, e.g., diabetes, pregnancy. CDI best practice.
  • Monitor blood glucose, HbA1c for diabetes management. Compliance essential.
  • Renal threshold assessment aids glucosuria interpretation. Improve documentation.
  • Exclude non-diabetic glucosuria causes, like pregnancy. Optimize coding.

Clinical Decision Support

Checklist
  • Confirm elevated urine glucose level (ICD-10 R81, SNOMED CT 268372005)
  • Evaluate serum glucose, HbA1c (diabetes screening)
  • Assess for renal glycosuria (eGFR, creatinine)
  • Review medications (SGLT2 inhibitors, steroids)

Reimbursement and Quality Metrics

Impact Summary
  • Glucosuria diagnosis coding impacts reimbursement through accurate ICD-10-CM code assignment (R81) and proper documentation supporting medical necessity for testing and treatment.
  • Quality metrics affected by Glucosuria diagnosis include diabetes management indicators (HbA1c levels, blood glucose control) and chronic kidney disease monitoring.
  • Accurate Glucosuria coding improves hospital reporting on diabetes prevalence, complications, and resource utilization for public health data and performance benchmarking.
  • Precise Glucosuria coding and documentation facilitate appropriate reimbursement for diabetes-related medications, supplies, and services, impacting hospital revenue cycle management.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code R81 for glucosuria screening
  • Confirm diabetes type with E08-E13 if present
  • Use additional codes for underlying causes
  • Document glucosuria severity and method
  • Check coding guidelines for pregnancy glucosuria

Documentation Templates

Patient presents with glucosuria, defined as glucose in urine, confirmed by urinalysis showing a positive glucose test.  Differential diagnosis includes diabetes mellitus type 1, diabetes mellitus type 2, gestational diabetes, renal glucosuria, and other causes of hyperglycemia.  Patient's medical history, family history, and current medications were reviewed.  Symptoms such as polyuria, polydipsia, polyphagia, weight loss, and fatigue were assessed.  Fasting blood glucose, HbA1c, and estimated average glucose levels were evaluated to determine the underlying cause of glucosuria and assess glycemic control.  Renal function tests, including serum creatinine and estimated glomerular filtration rate (eGFR), were ordered to evaluate for renal glucosuria.  Treatment plan includes further investigation to determine the etiology of glucosuria, focusing on diabetes management if indicated.  Patient education on lifestyle modifications, including diet, exercise, and glucose monitoring, was provided.  Referral to a specialist, such as an endocrinologist or nephrologist, may be considered based on diagnostic findings.  Follow-up appointment scheduled to monitor glucose levels, assess treatment efficacy, and adjust management plan as needed.  ICD-10 codes for glucosuria (R81) and related diagnoses will be used for medical coding and billing purposes.  CPT codes for relevant laboratory tests and procedures will also be documented.
Glucosuria - AI-Powered ICD-10 Documentation