We have learn a lot about diabetes coding perviously. Medical coders will know everything about different type of diabetes. Type 1 and 2 diabetes are the most commonly used diagnosis codes by medical coders.

But, if you know the ICD 10 coding book properly, you will have come across of diabetes type 1.5 ICD 10 code as well. Most of the coder are not aware of using this type of diabetes in coding. Even I was not aware of type 1.5 diabetes in ICD 10 coding.

The documentation should be very clear for coding type of diabetes. Below points should be checked before coding the type of diabetes.

• Type or cause of diabetes
  • Type 1
  • Type 2
  • Due to drugs or chemicals
  • Due to underlying condition
  • Other specified diabetes
• Body system complications related to diabetes, such as kidney or neurological complications
• Combination codes include diabetes and the manifestation
• Specific complications such as:
  • Chronic kidney disease
  • Foot ulcer
  • Hypoglycemia without coma

Read also: Diabetes complication in pregnancy Coding guide

Coding guidelines for type 1.5 diabetes.

Sometimes, a patient has a combination of both type 1 and type 2 diabetes. In such scenarios, when the diabetes is poorly controlled by combination of both type 1 & 2, in such case we can code a E13 category codes. The E13 category codes has type 1.5 diabetes.

Type 1.5 diabetes is a form of diabetes in which an adult has features of both type 1 and type 2 diabetes. These patients have also been described with the terms “latent autoimmune diabetes of adults” (LADA), and “slow-progressing type 1 diabetes.” The condition has also been called “double” diabetes, because individuals demonstrate both the autoimmune destruction of beta cells of type 1 diabetes and the insulin resistance characteristic of type 2 diabetes. People with type 1.5 diabetes have autoantibodies to insulin-producing beta cells and gradually lose their insulin-producing capability, requiring insulin within 5–10 years of diagnosis.

So, suppose we code E13.65, Other specified diabetes mellitus with hyperglycemia for type 1.5 diabetes, then we should also report any below secondary diagnosis if documented in the report.

Z79,4– Long term (current) use of insulin

Z79.84– Long term (current) use of oral hypoglycemic drugs