Endocrine Insider
October 29, 2008 

As of October 1, 2008, new codes for classifying secondary diabetes have been added to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding system. Previously, secondary diabetes was coded using ICD-9-CM code 251.8, a single code that was not specific to secondary diabetes but was used to categorize "other specified disorders of pancreatic internal secretion."  The new codes 249.00-249.91 allow for more specificity in identifying complications and level of control. 

The Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS), which creates and revises codes under the ICD system, approached The Endocrine Society in 2007 for comments on whether secondary diabetes required its own diagnosis code. The Society provided input indicating its support for new secondary diabetes diagnosis codes 249.00-249.91, specifying that the code should allow physicians to indicate level of control. The fourth digit of the new code provides for categorization based on type of complication and, in line with the Society's recommendation, the fifth digit differentiates between controlled and uncontrolled cases.  Providers must now use the new codes for secondary diabetes; failure to do so will cause instant rejections and unpaid claims.

For more information on ICD-9-CM coding for secondary diabetes, please see the NCHS webpage at www.cdc.gov/nchs/icd9.htm.