# ICD-10 E11.43--DM with gastroparesis-2 codes or 1?



## yrwhitley@novanthealth.org (Aug 27, 2015)

ICD-10 code E11.43 which has Type 2 diabetes with diabetic gastroparesis listed under this code, does not instruct to include code for gastroparesis. However K31.84 instructs to code first underlying disease if known, such as: diabetes, (one of which listed is E11.43). So, for diabetes with gastroparesis....require 2 codes or 1??


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## muthu0190 (Aug 28, 2015)

*DM & gastroparesis*

Yes both the codes must be coded !!


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## SalahuddinMuhammad (Aug 28, 2015)

*ICD-10 is simplified as compared to ICD-9*

In ICD-10 we need to give only one code for Type 2 diabetes with diabetic gastroparesis (complication affecting the body system), 

Read the ICD-10 guideline

4. Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00-E89)
a. Diabetes mellitus
The diabetes mellitus codes are *combination codes* that include the *type* of diabetes mellitus, the *body system affected*, and the complications affecting that body system.

So code only one code

See:
Alphabetic Index
Diabetes, diabetic (mellitus) (sugar) E11.9
- with
- - gastroparesis E11.43
Gastroparesis K31.84
- diabetic —see Diabetes, by type, with gastroparesis

Tabular Index
E11.43
Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
Type 2 diabetes mellitus with diabetic gastroparesis

Guidelines of coding combination code.
Section I:
B. General Coding Guidelines
9.Assign only the combination code when that code fully identifies the diagnostic conditions involved or when the Alphabetic Index so directs. Multiple coding should not be used when the classification provides a combination code that *clearly identifies all of the elements documented in the diagnosis*. When the combination code *lacks necessary specificity* in describing the manifestation or complication, an additional code should be used as a secondary code.

Here in the code E11.43 the second line in tabular index, it indicates : "Type 2 diabetes mellitus with diabetic gastroparesis" which includes both diabetes and gastroparesis, so no need to give additional gastroparesis code.

Thanks & Regards
Salahuddin, CPC
Hyderabad, India.


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## yrwhitley@novanthealth.org (Aug 28, 2015)

Well, now 2 different answers have been given. 
I understand the guidelines, but what throws me is the statement under K31.84 "Code first underlying disease, if known, such as: anorexia nervosa (F50.0-), diabetes mellitus 
(E08.43, E10.43, E11.43, E13.43), scleroderma (M34.-)"  
For any other code with those particular instructions to 'code first' means to code first those listed possibilites, followed by the code these directions appear under-- i.e. K31.84.


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## kumeena (Aug 28, 2015)

I agree with 1 code .


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## apoorba (Sep 1, 2015)

1 code only.. E11.43. Go by index. SalahuddinMuhammad has explained it properly. DM codes are combo codes in I10, unlike 2 codes that were reported in I9.


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## rolando.murillo (Jul 10, 2020)

Should be 2 codes, coding clinic instructs us to code both,


*Diabetic gastroparesis * 
      ICD-10-CM/PCS Coding Clinic, *Fourth Quarter 2013 *Pages: 114-115 Effective with discharges: October 21, 2013

*Question:*

What is the appropriate code assignment for diabetic gastroparesis?

*Answer:*

Assign first the code for the appropriate type of diabetes mellitus with diabetic autonomic (poly) neuropathy. Assign also code K31.84, Gastroparesis, if desired, to specify the actual neuropathic complication.

Although "diabetes mellitus with diabetic gastroparesis" is listed as an inclusion term under the appropriate diabetes codes (E08.43, E09.43,  E10.43, E11.43, and E13.43), the code titles are not specific for this condition. Therefore, it is               appropriate to assign a secondary code to identify the manifestation as gastroparesis.


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