Diabetes 1.5 or Latent Autoimmune DM

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kfreschlin

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I have seen only a few references to DM 1.5 (otherwise known as latent autoimmune DM apparently). It appears that this condition has been recognized for some time (I have found references back to 2004), but I can't find any recent guidance as to how to code for it. The last reference I can find for coding was something back in 2009 with ICD-9 codes. Can anyone point me to documents that would clarify how to code for it? I am surprised that ICD-10 code set was release without addressing this. Thanks!!
 
I've read that this isn't formally recognized as a separate type of diabetes, but is classified as a form of type 1 DM. The ICD-10 does have an 'includes' note under E10 that the Type 1 category includes 'diabetes (mellitus) due to autoimmune process', so that would be my recommendation for coding. I'd be interested to hear if anyone else knows of any formal guidelines on this.
 
Diabetes due to auto immune disease or LADA is coded as E10. There is an exclude 1 note under the E13 category that excludes diabetes due to autoimmune and to code ad E10.
 
Happy new year and thank you all for your responses. So, I guess the answer for now is E10.9 (if no complications are specified) unless someone else has any input and finds something other guidance.
 
Type 1.5 diabetes mellitus

Hi All,

As per the recent Coding clinic update, we can code E13 for Type 1.5 DM. Please refer below.

ICD-10-CM/PCS Coding Clinic, Third Quarter ICD-10 2018 Pages: 4-5 Effective with discharges: September 24, 2018

Question:

A 14-year-old female patient was seen in the Diabetes Clinic for a follow-up visit. The provider documented "Combination type 1 and type 2, diabetes mellitus in poor control." The provider was queried and confirmed both type 1 and type 2 diabetes. This condition is also called diabetes type 1.5. What is the correct diagnosis code assignment for diabetes 1.5?

Answer:

Assign codes from category E13, Other specified diabetes mellitus, for type 1.5 diabetes mellitus (combined type 1 and type 2). In this case, the provider specifically documented "combination type 1 and 2 diabetes mellitus in poor control"; therefore, assign code E13.65, Other specified diabetes mellitus with hyperglycemia.

Type 1.5 diabetes is a form of diabetes in which an adult has features of both type 1 and type 2 diabetes. These patients have also been described with the terms "latent autoimmune diabetes of adults" (LADA), and "slow-progressing type 1 diabetes." The condition has also been called "double" diabetes, because individuals demonstrate both the autoimmune destruction of beta cells of type 1 diabetes and the insulin resistance characteristic of type 2 diabetes. People with type 1.5 diabetes have autoantibodies to insulin-producing beta cells and gradually lose their insulin-producing capability, requiring insulin within 5-10 years of diagnosis.

Thanks,
Dorwin D, BPT, CPC, COC, CPMA, CANPC, CGSC
dr.dorwin@gmail.com
 
Last edited:
dr.dorwin said:
Type 1.5 diabetes mellitus

Hi All,

As per the recent Coding clinic update, we can code E13 for Type 1.5 DM. Please refer below.

ICD-10-CM/PCS Coding Clinic, Third Quarter ICD-10 2018 Pages: 4-5 Effective with discharges: September 24, 2018

Question:

A 14-year-old female patient was seen in the Diabetes Clinic for a follow-up visit. The provider documented "Combination type 1 and type 2, diabetes mellitus in poor control." The provider was queried and confirmed both type 1 and type 2 diabetes. This condition is also called diabetes type 1.5. What is the correct diagnosis code assignment for diabetes 1.5?

Answer:

Assign codes from category E13, Other specified diabetes mellitus, for type 1.5 diabetes mellitus (combined type 1 and type 2). In this case, the provider specifically documented "combination type 1 and 2 diabetes mellitus in poor control"; therefore, assign code E13.65, Other specified diabetes mellitus with hyperglycemia.

Type 1.5 diabetes is a form of diabetes in which an adult has features of both type 1 and type 2 diabetes. These patients have also been described with the terms "latent autoimmune diabetes of adults" (LADA), and "slow-progressing type 1 diabetes." The condition has also been called "double" diabetes, because individuals demonstrate both the autoimmune destruction of beta cells of type 1 diabetes and the insulin resistance characteristic of type 2 diabetes. People with type 1.5 diabetes have autoantibodies to insulin-producing beta cells and gradually lose their insulin-producing capability, requiring insulin within 5-10 years of diagnosis.

Thanks,
Dorwin D, BPT, CPC, COC, CPMA, CANPC, CGSC
dr.dorwin@gmail.com
Click to expand...
So you are suggesting that the Excludes 1 Diabetes (mellitus) due to autoimmune process should be ignored? The coding clinic example seems a bit contradictory in my opinion. LADA is diagnosed in "adulthood", usually over the age of 25yrs. This scenario was for a 14yr child.

Thanks,
Cindy Volsky, CPC, CDEO, CRC, CPMA, CPC-I
 
Cynthia0301 said:
So you are suggesting that the Excludes 1 Diabetes (mellitus) due to autoimmune process should be ignored? The coding clinic example seems a bit contradictory in my opinion. LADA is diagnosed in "adulthood", usually over the age of 25yrs. This scenario was for a 14yr child.

Thanks,
Cindy Volsky, CPC, CDEO, CRC, CPMA, CPC-I
Click to expand...

From what I have seen over the years, it is not the first time that the Coding Clinic has issued contradictory guidance.
 
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