The 2024 ICD-10-CM Updates Include New Codes for Reporting Metabolic Disorders and Insulin Resistance

September 19th, 2023 - Aimee Wilcox

The ICD-10-CM annual updates scheduled for implementation on October 1, 2023 include 395 new codes, 25 deleted codes, and a total of 13 revised codes. Among the newly added codes are codes that better define metabolic disorders such as metabolic syndrome, also known as insulin resistance syndrome, dysmetabolic syndrome, hypertriglyceridemic waist, obesity syndrome, and Syndrome X.

According to the National Institutes of Health (NIH), metabolic syndrome requires the presence of at least three of the following traits in a patient:

Metabolic syndrome is defined by The National Institutes of Health (NIH) as the presence of at at least three of the following traits:

Large waist
Elevated triglyceride level
Reduced HDL cholesterol
Increased blood pressure
Elevated fasting blood glucose

Patients with insulin resistance are at risk for developing metabolic syndrome, which the Cleveland Clinic defines as:

“Insulin resistance, also known as impaired insulin sensitivity, happens when cells in your muscles, fat and liver don’t respond as they should to insulin, a hormone your pancreas makes that’s essential for life and regulating blood glucose (sugar) levels. Insulin resistance can be temporary or chronic and is treatable in some cases.”

This means the body is unable to properly use insulin to move excess glucose into the cells and out of the bloodstream. When insulin is unable to do its job properly, this can lead not only to high blood glucose levels, but also weight issues, obesity, prediabetes, and diabetes. Diagnosing, documenting, and reporting insulin resistance is an important step in the diagnosis and treatment of this condition.

While there are several types of insulin resistance, Type A is the only one for which a new code was added to the ICD-10-CM updates for 2023. Type A insulin resistance is a rare genetic disorder resulting in mutation of the INSR gene, which prevents proper development of insulin receptors. Type B is another form of insulin resistance where the body’s own immune response is triggered, producing autoantibodies against the insulin receptor themselves resulting in malfunctioning of the way insulin wirks in the body.

The new updates are as follows:

E88.- Other and unspecified metabolic disorders

Use additional codes for associated conditions

Excludes1: histiocytosis X (chronic) (C96.6)

OLD E88.8 Other specified metabolic disorders

E88.81 Metabolic syndrome and other insulin resistance

Use additional codes for associated manifestations, such as:

Obesity (E66.-)

NEW E88.810 Metabolic syndrome

Dysmetabolic syndrome X

E88.811 Insulin resistance syndrome, Type A

E88.818 Other insulin resistance

Insulin resistance, Type B

E88.819 Insulin resistance, unspecified

When the documentation fails to identify a specific type of insulin resistance, be sure to report E88.819 for the unspecified type. However, if Type B is reported, or any other specifically-named type of insulin resistance, other than Type A, be sure to report E88.818 for other insulin resistance. While metabolic syndrome is also known as dysmetabolic syndrome and insulin resistance syndrome, as of October 1, 2023, there are new codes for insulin resistance that should be reported.

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