International Classification of Diseases, 10th Revision, Coding for Diabetes

ore than 29 million Americans have diabetes.The Centers for Disease Control and Prevention predict that the prevalence of diabetes will increase from 9% to >30% in the next 35 years (1).More than 21 million medical office visits for diabetes are scheduled each year (2).A total of one in five dollars spent on health care in the United States (and one in three dollars spent through Medicare) are spent on people with diabetes (3).With this in mind, proper and accurate coding for diabetes is a necessity.The International Classification of Diseases, 10th Revision-Clinical Modification (ICD-10) is designed to accurately classify and categorize all illnesses and diseases seen in the U.S. health care setting.(4) The coding system was updated in October 2015 to its 10th revision because it was thought that the 9th revision (ICD-9) no longer accommodated all of the new codes submitted to the system, and the ICD-9 codes were not descriptive enough to accurately reflect the state of patients' diseases.For example, the ICD-9 system had 13,000 three-to five-digit codes.This system was not able to take in new codes and did not include a way to designate laterality.The ICD-10 system has 68,000 codes that are three to seven digits each and has the capacity to expand.In general, ICD-10 codes can be up to seven characters long and are designed as follows: XXX.XXX.X (category.anatomicsite/severity.extension).The first set of digits before the first decimal point describes the general disease or category.The next three digits after the first decimal point describe the etiology, anatomical site, severity, or clinical detail.Finally, some conditions will have a second decimal point, followed by a final digit that may define an initial or subsequent encounter, the laterality of a condition, or the number of weeks' gestation (in the case of pregnancy).This may seem overly detailed, but it allows for greater specificity of the disease and its state.Most codes for diabetes will require four or five digits to provide the level of detail required by ICD-10 (5).This article provides key updates for ICD-10 coding for diabetes and its complications.To make sense of the coding descriptions, the authors will