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Coder worklist · Clinician screen · Chart

Staff surface Coder view

P17 KE-P17 · outpatient visit

One row per condition family: what the record supports under the published definition, what the note states, the visit's diagnosis entries, and an assessment. Codes are coded from the signed documentation; the software never assigns one.

Library check LRUN-00017 · library_default_set@1.0 · library-engine 1.0 · replay cdedba8ce66a3f42… · Data (JSON)

Condition families for this encounter (2)
Condition familyWhat the record supportsWhat the note states Visit diagnosis entriesAssessment
Diabetes mellitus
measured

ada2026_diabetes@1.0 Draft · pending review

Diabetes criteria met: two abnormal results (different tests, or the same test at two times)

  • hba1c 7.4 % 2026-11-12 10:05 · LM-P17-02

Window: 730 days before the check.

Citation

Diabetes diagnostic thresholds and the confirmation rule (ADA Standards of Care 2026)

ada2026_diabetes@1.0
Table 2.1: A1C ≥6.5% (≥48 mmol/mol); FPG ≥126 mg/dL (≥7.0 mmol/L); 2-h PG ≥200 mg/dL (≥11.1 mmol/L) during OGTT; random plasma glucose ≥200 mg/dL (≥11.1 mmol/L) with classic symptoms of hyperglycemia or hyperglycemic crisis. In the absence of unequivocal hyperglycemia, diagnosis requires two abnormal results from different tests ... or the same test at two different time points.

American Diabetes Association Professional Practice Committee, 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026 (2026) · Table 2.1 Criteria for the diagnosis of diabetes in nonpregnant individuals · source

Not encoded: Type of diabetes (type 1, type 2, other) is not assessed. Conditions that make A1C unreliable (some haemoglobin variants, pregnancy, G6PD deficiency, HIV, anaemia, haemodialysis, erythropoietin; recommendation 2.4 and text) are not checked: A1C results are used as sent. No maximum interval between the two abnormal results is stated by the source and none is applied. Whether the test method is NGSP-certified and whether a fasting sample was truly fasting are asserted by the sender through the analyte name. When two different tests are discordant ADA advises repeating the abnormal test; this entry simply reports one abnormal result.

Diabetes

DM2

E11.9 DM2 (encounter diagnosis list)

Supported and specific

Code-family reference: Diabetes mellitus Coders only

reference for coders — the clinician's documented statement governs; the software does not assign codes

E11 Type 2 diabetes mellitus: distinguishes type 2 diabetes with or without complications by body system (kidney, eye, nerve, circulatory, skin, oral, hypoglycaemia, hyperglycaemia, ketoacidosis, hyperosmolarity), long-term drug use is separate (Z79) (87 codes in the category).

87 codes; see the official files

E10 Type 1 diabetes mellitus: distinguishes type 1 diabetes with the same complication axes as E11 (87 codes in the category).

87 codes; see the official files

Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).

Prediabetes
measured

ada2026_prediabetes@1.0 Draft · pending review

Criteria not met: A result is in the diabetes range — prediabetes not assigned; see ada2026_diabetes

  • hba1c 7.4 % 2026-11-12 10:05 · LM-P17-02

Window: 365 days before the check.

Citation

Prediabetes ranges (ADA Standards of Care 2026)

ada2026_prediabetes@1.0
A1C 5.7–6.4% (39–47 mmol/mol); FPG 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L) (IFG); 2-h PG during 75-g OGTT 140 mg/dL (7.8 mmol/L) to 199 mg/dL (11.0 mmol/L) (IGT)

American Diabetes Association Professional Practice Committee, 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026 (2026) · Table 2.2 Criteria defining prediabetes in nonpregnant individuals · source

Contested: Other bodies (for example WHO) are understood to use a different impaired fasting glucose range and not to use an A1C prediabetes range; those texts were not opened, so no other thresholds are recorded. Review item.

Not encoded: ADA does not require confirmation for prediabetes in Table 2.2; none is applied. A1C reliability conditions are not checked (see ada2026_diabetes). Only the most recent result of each test is used.

Not stated

None entered

Nothing to act on

Code-family reference: Prediabetes Coders only

reference for coders — the clinician's documented statement governs; the software does not assign codes

R73 Elevated blood glucose level: distinguishes R73.01 impaired fasting glucose, R73.02 impaired glucose tolerance (oral), R73.03 prediabetes, R73.09 other abnormal glucose, R73.9 hyperglycaemia unspecified (5 codes in the category).

  • R73.01 Impaired fasting glucose
  • R73.02 Impaired glucose tolerance (oral)
  • R73.03 Prediabetes
  • R73.09 Other abnormal glucose
  • R73.9 Hyperglycemia, unspecified

Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).