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Home/Diagnosis/ICD-10 Coding for Prediabetes

ICD-10 Coding for Prediabetes

R73.03
R73.09

Complete ICD-10-CM coding and documentation guide for icd-10 coding for prediabetes includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Impaired Glucose Tolerance
Impaired Fasting Glucose
Borderline Diabetes
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Key Information: ICD-10 Coding for Prediabetes

Essential facts and insights about ICD-10 Coding for Prediabetes

Use ICD-10 code R73.03 for prediabetes, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Prediabetes

Billable Code
R73.03
Billable

Diagnostic Criteria

clinical:
  • • Fasting Plasma Glucose (FPG) 100-125 mg/dL
  • • A1C 5.7-6.4%
  • • Oral Glucose Tolerance Test (OGTT) 140-199 mg/dL
documentation:
  • • Documented lab values supporting prediabetes diagnosis

Applicable To

  • • Impaired fasting glucose
  • • Impaired glucose tolerance

Important Notes

  • • Ensure lab results are documented to support the use of R73.03

Other abnormal glucose

Billable Code
R73.09
Billable

Diagnostic Criteria

clinical:
  • • Lab results indicating abnormal glucose not meeting prediabetes criteria

Important Notes

  • • Ensure documentation clearly indicates why prediabetes criteria are not met
Ancillary Codes

Additional codes that may be used with this diagnosis

Z68.3x

Body mass index (BMI) 30.0-39.9, adult

Use to document obesity as a risk factor

Z13.1

Encounter for screening for diabetes mellitus

Use for screening encounters, especially with risk factors present

Frequently Asked Questions

What is the ICD-10 code for prediabetes?

The ICD-10 code for prediabetes is R73.03, used when lab results confirm prediabetes criteria such as FPG 100-125 mg/dL or A1C 5.7-6.4%.

How do you code a screening for prediabetes?

Use Z13.1 for screening encounters, especially with risk factors like obesity, and apply the TS modifier for Medicare screenings.

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