Wiki LADA (latent autoimmune diabetes in adults)

[ch0507449@gmail.com]

After doing some research, I have found conflicting information on what the best code would be to use for a LADA (latent autoimmune diabetes in adults) dx. I know if you look up diabetes due to autoimmune process it directs you to use a diabetes type 1 dx, which has an includes note of "diabetes (mellitus) due to autoimmune process". However, I have also seen people say they are using the E13 codes since LADA is a mixture of Type 1 and Type 2 and not specific to Type 1 and my encoder is also suggesting that I use E13. In your experience which would be better to use, E10 or E13?

 

[dballard2004]

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.

Based on this guidance, LADA is coded from the E13 category.