ICD-10 Code R73.03

R73.03 is an ICD-10-CM code used to denote "prediabetes." This code is specifically used to identify patients who exhibit elevated blood glucose levels that do not meet the criteria for diabetes mellitus, but are higher than normal and indicate a risk of developing diabetes in the future.

Prediabetes, coded as R73.03, refers to a condition where blood glucose levels are elevated beyond the normal range but not high enough to be classified as diabetes. This condition is a significant indicator of increased risk for developing type 2 diabetes, cardiovascular diseases, and other metabolic disorders. The diagnosis of prediabetes is primarily based on blood tests such as fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and hemoglobin A1c (HbA1c).

Patients with prediabetes (R73.03) often do not exhibit overt symptoms. However, some individuals may experience signs that are linked to elevated blood sugar levels, such as:

It is important to note that many individuals with prediabetes may remain asymptomatic.

The code R73.03 should be used for billing when a patient has been diagnosed with prediabetes based on specific diagnostic criteria. An additional term that is coded as R73.03 when documented is “latent diabetes.” It is an important consideration for providers to document the diagnostic tests and their results to justify the use of this code. This ensures accurate billing and reimbursement for services related to the management and monitoring of prediabetes.

When coding for prediabetes with R73.03, adhere to the following guidelines:

There is an excludes 1 note found at category R73, elevated blood glucose level that applies to code R73.03 for the following conditions:

Due to this instructional note, when the patient has been diagnosed with one of the listed conditions, only the condition noted in the Excludes 1 note should be assigned and R73.03 would be omitted.

Common pitfalls to avoid when coding with R73.03 include:

Key resources for accurate coding of R73.03 include:

R73.03 is an ICD-10-CM code that identifies patients with prediabetes, a condition characterized by elevated blood glucose levels that are not yet in the diabetic range. Accurate coding and documentation are vital for proper patient management, billing, and reimbursement. By adhering to coding guidelines and best practices, healthcare providers can ensure effective monitoring and intervention for patients at risk of developing diabetes.

Tebra’s EHR+ gives you quick searches and Systematized Nomenclature of Medicine (SNOMED) field names for efficient code documentation. Plus, Tebra automatically saves ICD-10 to SNOMED mapping for future searches, streamlining your workflow.

Discover how Tebra helps providers effortlessly document health-related issues and conditions in this detailed post.