Find comprehensive information on Hyperosmolar Hyperglycemic State diagnosis, including clinical documentation tips, ICD-10 codes (E11.1, E14.1), medical coding guidelines, and healthcare best practices for HHS management. Learn about HHS symptoms, treatment protocols, and the differences between HHS and DKA. This resource provides essential information for healthcare professionals, clinicians, and medical coders seeking accurate and up-to-date guidance on Hyperosmolar Hyperglycemic Syndrome.
Also known as
Diabetes mellitus
Disorders of glucose metabolism, including hyperosmolar hyperglycemic state.
Volume depletion
Conditions related to fluid loss, often associated with HHS.
Other disorders of fluid, electrolyte, and acid-base balance
Includes electrolyte imbalances commonly seen in HHS like hypernatremia and hyperkalemia.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the primary diagnosis Hyperosmolar Hyperglycemic State?
Yes
Is there a documented nonketotic coma?
No
Do not code as Hyperosmolar Hyperglycemic State. Review clinical documentation for alternative diagnosis.
When to use each related code
| Description |
|---|
| Hyperosmolar Hyperglycemic State |
| Diabetic Ketoacidosis |
| Uncontrolled Diabetes Mellitus |
Patient presents with hyperosmolar hyperglycemic state (HHS), a serious metabolic complication of diabetes mellitus, typically type 2 diabetes. Onset was gradual with presenting symptoms including polyuria, polydipsia, polyphagia, and weight loss over the past [Number] daysweeks. The patient exhibits signs of severe dehydration, including dry mucous membranes, tachycardia, and hypotension. Neurological symptoms such as altered mental status, ranging from confusion to coma, are also noted. Laboratory findings reveal marked hyperglycemia (blood glucose greater than 600 mgdL), elevated serum osmolality (greater than 320 mOsmkg), and absence of significant ketoacidosis. Serum electrolytes show hypernatremia, hypokalemia, and elevated blood urea nitrogen (BUN) and creatinine, indicative of acute kidney injury secondary to dehydration. Urinalysis reveals glucosuria without significant ketonuria. Differential diagnoses considered include diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar nonketotic syndrome (HHNS), and dehydration due to other causes. The diagnosis of HHS is based on the clinical presentation, hyperglycemia, hyperosmolality, and absence of significant ketosis. Treatment plan includes aggressive fluid resuscitation with intravenous isotonic saline to correct dehydration and restore intravascular volume, continuous intravenous insulin infusion to lower blood glucose levels, and close monitoring of electrolytes, renal function, and mental status. Electrolyte imbalances, particularly potassium, will be corrected as needed. The patient will be closely monitored for potential complications such as cerebral edema, acute kidney injury, and thromboembolic events. Patient education will focus on diabetes management, including medication adherence, blood glucose monitoring, and recognition of early signs and symptoms of HHS. Coding will likely include ICD-10-CM code E11.10 for type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma, and additional codes to reflect complications such as acute kidney injury. Medical billing will reflect the level of care provided, including intensive care unit (ICU) admission if required.