Diabetic neuropathy is one of the most common chronic complications of Type 2 Diabetes Mellitus (T2DM), affecting up to 50% of diabetic patients over time. It can present in various forms, including peripheral, autonomic, and focal nerve damage. When a patient with T2DM develops neuropathy but the specific type is not clearly documented, ICD-10 code E11.40 is used.
This article explains how to properly apply E11.40, when to use more specific alternatives like E11.42, how to document diabetic neuropathy, and tips to avoid common coding errors.
When to Use ICD-10 Code E11.40
Use E11.40 when:
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The patient has a confirmed diagnosis of Type 2 diabetes
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There is evidence or diagnosis of neuropathy
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The type of neuropathy is not specified or documented (e.g., no mention of peripheral vs. autonomic)
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No other complication codes better describe the neuropathy
Note: If the type of neuropathy is clearly documented (e.g., peripheral), use E11.42 instead for higher specificity.
Key Clinical Indicators
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Paresthesias (tingling, numbness)
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Burning or shooting pain in limbs
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Muscle weakness, especially in lower extremities
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Decreased reflexes or vibratory sensation
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Autonomic symptoms (if unspecified)
E11.40 vs. Other Neuropathy Codes
| ICD-10 Code | Diagnosis | When to Use |
|---|---|---|
| E11.40 | T2DM with diabetic neuropathy, unspecified | Neuropathy present, but type not documented |
| E11.42 | T2DM with diabetic polyneuropathy | Peripheral nerve involvement documented |
| G62.9 | Neuropathy, unspecified | Use with caution; not specific to diabetes |
| G63 | Polyneuropathy in diseases classified elsewhere | Rarely used; not common in diabetic context |
Sample Clinical Scenarios
| Scenario | ICD-10 Code(s) |
|---|---|
| T2DM with “nerve pain in feet,” unclear type | E11.40 |
| T2DM with documented “diabetic peripheral neuropathy” | E11.42 |
| T2DM with autonomic neuropathy and gastroparesis | E11.43 + K31.84 |
| T2DM with lower limb numbness, no clear documentation | E11.40 |
Documentation Guidelines for E11.40
To justify the use of E11.40 in your documentation:
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Confirm Type 2 diabetes diagnosis
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Note clinical signs/symptoms: pain, numbness, tingling, weakness
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State “neuropathy related to diabetes” explicitly
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Avoid vague statements like “nerve pain” unless further clarified
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If performing exams (monofilament, vibration, reflexes), document findings
Sample Note:
“Patient with long-standing T2DM, reports numbness and burning in both feet for 6 months. Exam: decreased sensation to monofilament and vibration in bilateral feet. No mention of autonomic dysfunction or specific neuropathy type. Diagnosis: Type 2 diabetes with diabetic neuropathy, unspecified (E11.40). Plan: Begin gabapentin; refer to podiatry.”
SOAP Note Example – E11.40
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S: “Feet burn at night, feels like pins and needles.”
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O: Decreased sensation in feet to monofilament; no skin breakdown
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A: Type 2 diabetes with diabetic neuropathy, unspecified (E11.40)
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P: Start gabapentin 300 mg at bedtime, schedule foot exam, order labs
Management of Diabetic Neuropathy
| Treatment Category | Examples |
|---|---|
| Pharmacologic | Gabapentin, Pregabalin, Duloxetine |
| Glycemic Control | Tight A1c control slows progression |
| Foot Care | Daily inspection, podiatry referrals |
| Physical Therapy | Improves strength and gait stability |
| Fall Prevention | Home safety assessment, mobility aids |
Related Codes Commonly Used with E11.40
| Clinical Detail | ICD-10 Code |
|---|---|
| Insulin use | Z79.4 |
| Chronic oral hypoglycemic use | Z79.84 |
| Diabetic foot exam | Z13.89 |
| Diabetic foot ulcer (if present) | E11.621 + L97.x |
| Peripheral vascular disease | I73.9 |
| Neuropathy as primary symptom | G62.9 (if not diabetes-related) |
Common Mistakes to Avoid
| Error | Better Approach |
|---|---|
| Using E11.9 (uncomplicated diabetes) when neuropathy is present | Use E11.40 or E11.42 instead |
| Using G62.9 alone | Use E11.40 if neuropathy is diabetic-related |
| Not linking diabetes to neuropathy | Always document: “neuropathy due to diabetes” |
| Failing to document exam findings | Include sensory exam, monofilament, reflexes |
FAQs
Should I use E11.40 or E11.42?
If neuropathy is clearly described as peripheral, use E11.42. If not specified, or documentation is vague, E11.40 is appropriate.
Can E11.40 be coded if the neuropathy is only suspected?
Yes, if the clinician documents it as suspected or probable diabetic neuropathy, it can be coded, but confirmation is preferred.
Can I use E11.40 for patients with tingling or numbness only?
Yes—if the symptoms are linked to diabetes and no other cause is documented, E11.40 is valid.
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Conclusion
ICD-10 Code E11.40 is critical for accurately capturing diabetic neuropathy when the specific type is not identified in documentation. With high prevalence and significant clinical implications, properly coding and managing diabetic nerve complications is vital. Platforms like DocScrib help streamline your documentation, improve audit protection, and support high-quality care.