Cracking the Code

Secondary Diabetes

When coding diabetes, it is important that medical coders read the provider’s documentation thoroughly and understand what condition is being listed. In some cases, providers may state that patients have secondary diabetes. Secondary diabetes is a diabetic condition that develops after the destruction of pancreatic beta cells and/or hormonal syndromes that interfere with insulin secretion. A patient may have a disorder such as pancreatitis, cystic fibrosis, or pancreatic cancer that causes secondary diabetes. Pay close attention to sequencing instructions per coding guidelines. Per instructions under the Tabular index for category E08, it is accurate to report the underlying condition as the primary diagnosis and secondary diabetes (E08.-) as a secondary diagnosis. Before assigning the secondary diabetes diagnosis, be sure that the provider EXPLICITLY links the two conditions together.

Q: A 57-year-old woman presents to the ED with complaints of rapid weight loss and fatigue. The patient has chronic pancreatitis. After the provider completes a blood test, the patient is diagnosed with secondary diabetes due to chronic pancreatitis.
A: K86.1, other chronic pancreatitis
E08.9, diabetes mellitus due to underlying condition without complications (manifestation)
Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 Section I.C.4.a.6.b.
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