The 2024 ICD-10-CM Updates Include New Codes for Reporting Metabolic Disorders and Insulin Resistance
Date Posted: Tuesday,
October 10, 2023
The ICD-10-CM annual updates scheduled for implementation on October 1, 2023, include 395 new codes, 25 deleted codes, and a total of 13 revised codes. Among the newly added codes are codes that better define metabolic disorders, such as metabolic syndrome, also known as insulin resistance syndrome, dysmetabolic syndrome, hypertriglyceridemic waist, obesity syndrome, and Syndrome X.
Metabolic syndrome is defined by the National Institutes of Health (NIH) as the presence of at least three of the following traits:
- Large waist
- Elevated triglyceride level
- Reduced HDL cholesterol
- Increased blood pressure
- Elevated fasting blood glucose
Patients with insulin resistance are at risk for developing metabolic syndrome, which the Cleveland Clinic defines as:
"Insulin resistance, also known as impaired insulin sensitivity, happens when cells in your muscles, fat, and liver don't respond as they should to insulin, a hormone your pancreas makes that's essential for life and regulating blood glucose (sugar) levels. Insulin resistance can be temporary or chronic and is treatable in some cases."
This means the body is unable to properly use insulin to move excess glucose into the cells and out of the bloodstream. When insulin is unable to do its job properly, this can lead not only to high blood glucose levels, but also weight issues, obesity, prediabetes, and diabetes. Diagnosing, documenting, and reporting insulin resistance is an important step in the diagnosis and treatment of this condition.
While there are several types of insulin resistance, Type A is the only one for which a new code was added to the ICD-10-CM updates for 2023. Type A insulin resistance is a rare genetic disorder resulting in mutation of the INSR gene, which prevents proper development of insulin receptors. Type B is another form of insulin resistance where the body's own immune response is triggered, producing autoantibodies against the insulin receptor themselves, resulting in malfunctioning of the way insulin works in the body.
The new updates are
as follows:
- E88.- - Other and unspecified
metabolic disorders
- Use additional codes for associated conditions
- Excludes1: histiocytosis X (chronic) (C96.6)
Old: - E88.8 - Other specified metabolic disorders
- E88.81 Metabolic syndrome and other insulin resistance
- Use additional codes for associated manifestations, such as Obesity - E66.-
New: - E88.810 - Metabolic syndrome, Dysmetabolic syndrome X
- E88.811 - Insulin resistance syndrome, Type A
- E88.818 - Other insulin resistance, Insulin resistance, Type B
- E88.819 Insulin resistance, unspecified
When the documentation fails to identify a specific type of insulin resistance, be sure to report E88.819 for the unspecified type. However, if Type B is reported, or any other specifically-named type of insulin resistance, other than Type A, be sure to report E88.818 for other insulin resistance. While metabolic syndrome is also known as dysmetabolic syndrome and insulin resistance syndrome, as of October 1, 2023, there are new codes for insulin resistance that should be reported.
Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, is a medical coding, billing, and auditing consultant, author, and educator with more than 30 years of clinical and administrative experience in healthcare, coding, billing, and auditing. Medicine, including coding and billing, is a constantly changing field full of challenges and learning and she loves both. Aimee believes there are talented medical professionals who, with proper training and excellent information, can continue to practice the art of healing while feeling secure in their billing and reimbursement for such care.
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