E13.65

Billable

Other specified diabetes mellitus with hyperglycemia

HCC Category Mapping

V28HCC 38 — Diabetes without Complication

0.450

V24HCC 18 — Diabetes with Chronic Complications

0.302

ESRDHCC 18 — Diabetes with Chronic Complications

0.000

RxHCCHCC 30 — Diabetes with Complications

0.000

What This Code Means

A type of diabetes (not type 1 or type 2) with abnormally high blood sugar levels.

Coding Tips

•This code indicates elevated blood glucose; document the specific glucose level if available
•Distinguish between hyperglycemia with or without ketoacidosis

Clinical Significance

E13.65 identifies hyperglycemia in other specified diabetes mellitus, indicating that the patient's blood glucose is not adequately controlled. Persistent hyperglycemia accelerates microvascular and macrovascular complications, increasing the risk of nephropathy, retinopathy, neuropathy, and cardiovascular disease in patients with secondary diabetes.

Documentation Requirements

✓Documentation must confirm secondary diabetes with hyperglycemia.
✓Elevated blood glucose levels, hemoglobin A1c values, and the clinical context (medication non-adherence, illness, steroid use) should be documented.
✓The provider should describe the treatment plan for addressing the hyperglycemia.

Commonly Confused Codes

E13.649 (hypoglycemia without coma) which is the opposite metabolic derangement E13.9 (without complications) when blood sugar is controlled R73.9 (hyperglycemia unspecified) for non-diabetic hyperglycemia or prediabetes.

Code Hierarchy

└E13Other specified diabetes mellitus └E13.6Other specified diabetes mellitus with other specified complications └E13.65Other specified diabetes mellitus with hyperglycemia

└E13.65Other specified diabetes mellitus with hyperglycemia