Find information on Type 2 Diabetes with Peripheral Neuropathy diagnosis, including clinical documentation, ICD-10 codes (E11.4, G63.2), medical coding guidelines, and healthcare management best practices. Learn about symptoms, diagnostic criteria, and treatment options for diabetic neuropathy. Explore resources for healthcare professionals on accurate coding and documentation for optimal reimbursement.
Also known as
Type 2 diabetes with polyneuropathy
Type 2 diabetes with peripheral nerve damage.
Mononeuropathy of lower limb
Damage to a single peripheral nerve in the leg.
Other specified peripheral neuropathies
Peripheral neuropathy not otherwise specified.
Type 2 DM with autonomic neuropathy
Type 2 diabetes affecting the autonomic nerves.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diabetes Type 2?
Yes
Is peripheral neuropathy present?
No
Do not code as Type 2 diabetes with peripheral neuropathy. Review diagnosis and code appropriately.
When to use each related code
| Description |
|---|
| Type 2 diabetes with neuropathy |
| Diabetic polyneuropathy |
| Type 2 diabetes with foot ulcer |
Coding E11.40 lacks specificity if laterality, upper vs lower, or site is documented, impacting reimbursement and quality metrics. CDI can query for detail.
Coding E11.4 requires confirmed T2DM. Auditors may deny claims if documentation lacks sufficient evidence of established diagnosis, impacting revenue integrity.
Missing documentation of diabetic peripheral neuropathy impacts HCC risk adjustment scores and proper reimbursement. CDI should ensure accurate capture for RAF scores.
Q: What are the most effective evidence-based strategies for managing painful diabetic peripheral neuropathy in patients with Type 2 Diabetes, considering both pharmacological and non-pharmacological approaches?
A: Managing painful diabetic peripheral neuropathy (DPN) in Type 2 Diabetes requires a multimodal approach encompassing both pharmacological and non-pharmacological interventions. Pharmacological options supported by strong evidence include pregabalin, duloxetine, and gabapentinoids, targeting neuropathic pain mechanisms. Topical agents like capsaicin or lidocaine patches can offer localized pain relief. Non-pharmacological strategies are crucial and include patient education on blood glucose control, regular exercise, and optimizing nutrition. Explore how structured exercise programs and dietary modifications can positively influence neuropathy progression. Consider implementing validated patient-reported outcome measures like the Douleur Neuropathique 4 (DN4) questionnaire to accurately assess pain severity and monitor treatment response. Learn more about combining pharmacological and non-pharmacological strategies for a comprehensive DPN management plan.
Q: How can clinicians differentiate between Type 2 Diabetic Peripheral Neuropathy and other neuropathies presenting with similar symptoms, considering diagnostic criteria and differential diagnosis best practices?
A: Differentiating Type 2 Diabetic Peripheral Neuropathy (DPN) from other neuropathies requires a thorough clinical evaluation. Key diagnostic criteria for DPN include a history of Type 2 Diabetes, presence of characteristic symptoms like burning, tingling, or numbness, and objective findings such as reduced vibration perception or abnormal nerve conduction studies. Clinicians must consider other potential causes of neuropathy, including vitamin deficiencies (B12, B6), hypothyroidism, alcohol-induced neuropathy, and autoimmune conditions. Differential diagnosis involves careful review of patient history, physical examination focusing on neurological assessment, and appropriate laboratory tests to rule out alternative diagnoses. Consider implementing a structured diagnostic approach utilizing clinical guidelines and algorithms to enhance diagnostic accuracy in differentiating DPN from other neuropathies. Explore how electrodiagnostic studies can assist in confirming the diagnosis and assessing the severity of nerve damage.
Patient presents with symptoms consistent with type 2 diabetes and peripheral neuropathy. The patient reports gradual onset of numbness, tingling, and burning pain in the feet, particularly at night. Symptoms also include occasional sharp, shooting pains and decreased sensation to temperature and touch. The patient also complains of increased thirst, frequent urination, and fatigue. Medical history includes hypertension and hyperlipidemia. Family history is positive for type 2 diabetes. Physical examination reveals decreased sensation to monofilament testing in both feet, diminished ankle reflexes, and dry skin. Fasting blood glucose is elevated at 145 mgdL. HbA1c is 8.2%. Assessment: Type 2 diabetes mellitus with peripheral neuropathy. Plan: Initiate metformin, educate patient on diabetes management including diet, exercise, and blood glucose monitoring. Prescribe gabapentin for neuropathic pain management. Refer to podiatry for foot care evaluation and diabetic footwear education. Follow-up scheduled in 2 weeks to assess treatment response and adjust medication as needed. Differential diagnoses considered include other causes of peripheral neuropathy such as vitamin B12 deficiency and hypothyroidism, which were ruled out based on normal laboratory results. Patient education provided on the importance of medication adherence, regular foot exams, and blood glucose control to prevent further complications. ICD-10 codes E11.4 and G63.2 are documented for billing purposes.