E11.00

HCC Category Mapping

What This Code Means

Type 2 diabetes with very high blood sugar and blood osmolarity (salt concentration) but without the patient being in a coma.

Coding Tips

• •Hyperosmolarity is a serious condition; document blood glucose and osmolarity levels when available
• •Distinguish from E11.01 which indicates the patient is in a coma from this condition

Clinical Significance

Type 2 diabetes mellitus with hyperosmolarity without coma is a serious acute metabolic decompensation where extreme hyperglycemia causes dangerously high blood osmolarity, leading to severe dehydration. This condition, known as hyperosmolar hyperglycemic state, typically occurs in elderly Type 2 diabetic patients and carries mortality rates of 10-20%. Unlike diabetic ketoacidosis, significant ketone production is usually absent.

Documentation Requirements

• ✓Documentation must confirm Type 2 diabetes with hyperosmolarity and explicitly state the patient is not in a coma.
• ✓Blood glucose levels (often exceeding 600 mg/dL), serum osmolarity values, and hydration status should be recorded.
• ✓The precipitating cause (infection, medication non-adherence, new diagnosis) and treatment with aggressive fluid resuscitation should be documented.

Commonly Confused Codes