NOTE: All in-article links open in a new tab.

Coding Diabetes Mellitus with Conditions Not Elsewhere Classified (NEC)

Published on 

Wednesday, November 10, 2021

 | FAQ 
 | Coding 

If a provider has documented diabetes and arthritis, can we code it to diabetes with arthropathy (E11.618)?

Diabetes, diabetic (mellitus) (sugar) (E11.9)




No. Even though the ICD-10 Alphabetic Index has an entry for ‘Diabetes with Arthropathy NEC’, the provider needs to document the relationship between the two conditions; we cannot assume a causal relationship when a diabetic complication is “NEC”.

The “with” guideline does not apply to “not elsewhere classified (NEC)” conditions indexed to broad categories. The specific condition must be linked by the terms “with”, “due to” or “associated with”.

Arthropathy is a general term for any condition that affects the joints. There are many different types of arthropathic conditions that may not be due to diabetes. To link diabetes and arthritis, the provider needs to document the condition as a diabetic complication.

Please be aware of all diabetic NEC complications listed in the Alphabetic Index:

  • Arthropathy NEC
  • Circulatory complication NEC
  • Complication, specified NEC
  • Kidney complications NEC
  • Neurologic complication NEC
  • Oral complication NEC
  • Skin complication NEC
  • Skin ulcer NEC
  • ICD-10-PCS Official Coding Book
  • Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2017: Pages 100-101
  • Coding Clinic for ICD-10-CM/PCS, Second Quarter 2018: Page 6
Article Author: Susie James, RHIT, CCS
Susie James, RHIT, CCS, is the Manager of Inpatient Coding Services at MMP, Inc. Susie has worked in the coding field for over 30 years and has worked as a coder, coding supervisor, and corporate coding manager for a large multi-facility system in Birmingham. She also worked for Alabama Quality Assurance Foundation (AQAF) as a coding reviewer/auditor before joining the team at Medical Management Plus, Inc. Susie has previously served as the President of the Alabama Association of Health Information Management (AAHIM) on the Board of Directors and currently serves as the Education/Coding Roundtable Chair. She is also a member of the American Health Information Management Association (AHIMA) and has previously served as the Co-chair for AHIMA's Leadership Team. She also served as a facilitator at AHIMA's 85th National Convention in Atlanta Georgia.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.