Internal Medicine Coding Alert

Question: Our internist wants a diagnosis code for "hypoglycemic unawareness." The best I can come up with is 250.8x. Is there a better code to use?


Colorado Subscriber

Answer: Diagnosis code 250.8x (Diabetes with other specified manifestations) does list diabetic hypoglycemia and hypoglycemic shock as conditions you could report with this code. You could list 250.8x to report hypoglycemic unawareness because the code indicates the diabetic hypoglycemia. But this code does not account for the dulled nervous response that causes the "unawareness."

Many times a form of neuropathy causes the patient's dulled response to hypoglycemia. Nerve damage from diabetes can be internal as well as external, harming even the body's automatic responses. If this is the case, check with your internist to see if you can list 250.6x (Diabetes with neurological manifestations).
 
Remember: Neuropathy is not always the cause of hypoglycemic unawareness, so you should check with your physician first to determine if 250.6 would be an appropriate code.