E11.649

HCC Category Mapping

What This Code Means

This code describes a patient with type 2 diabetes who is experiencing low blood sugar (hypoglycemia) but is still conscious and alert. Hypoglycemia is a dangerous condition where blood glucose drops too low, causing symptoms like shakiness, sweating, and confusion.

Coding Tips

• •Verify documentation clearly states both type 2 diabetes AND hypoglycemia without coma; do not assume hypoglycemia is present without explicit provider documentation
• •The .649 extension specifically indicates hypoglycemia without loss of consciousness; if the patient lost consciousness or had a hypoglycemic coma, use E11.641 instead

Clinical Significance

Type 2 diabetes mellitus with hypoglycemia without coma is a common acute complication that can occur with insulin therapy, sulfonylureas, or meglitinides. Episodes range from mild (self-treated with oral glucose) to severe (requiring assistance but without loss of consciousness). Recurrent hypoglycemia may lead to hypoglycemia unawareness, where patients lose the ability to detect early warning symptoms, dramatically increasing the risk for severe episodes and falls.

Documentation Requirements

• ✓The medical record must document a hypoglycemic episode in a Type 2 diabetic patient with confirmation that coma did not occur.
• ✓Blood glucose readings, symptoms experienced, precipitating medications, and treatment provided should be recorded.
• ✓Frequency of episodes, medication adjustments made, and patient education regarding hypoglycemia recognition and management should be documented.

Commonly Confused Codes