Several studies since the 1990s have. If possible, test your blood sugar with a finger-stick test. 355. Hypoglycemia, also known as low blood sugar or low blood glucose, is when blood sugar decreases to below normal levels. Location. In addition, many studies analyze the frequency of severe hypoglycemia, while non-severe events or even hypoglycemia unawareness can also have significant impact on well-being. This state of hypoglycemia unawareness is characterized by a failure of glucagon release, preventing mobilization of endogenous glucose stores from the liver. The overall rate of severe. Lower. 649 With hyperglycemia E10. Knowing how to identify low blood sugar is important because it can be dangerous if left untreated. ICD-10-CM Diagnosis Code E11. 1-4 However, the role of complications of diabetes as possible mechanisms in dementia has not been well studied. However,. The International Classification of Diseases, 10th Revision—Clinical Modification (ICD-10) is designed to accurately classify and categorize all illnesses and diseases seen in the U. hypoglycemia unawareness is loss of the warning, almost exclusively neurogenic symptoms of developing hypoglycemia that previously prompted the individual to act (e. Diabetes 1 with hypoglycemia unawareness; Diabetes type 1 with hypoglycemia; Hypoglycemia due to type 1 diabetes mellitus; Unawareness of hypoglycemia in type 1 diabetes mellitus. 649, E10. from publication: Hospitalization with hypoglycemia in patients without diabetes mellitus: A retrospective study using a. Insulin is a hormone that signals cells to take up sugar from the blood, thus lowering blood sugar. Showing 1-25: ICD-10-CM Diagnosis Code E13. Though low blood glucose symptoms may vary from person to person, here are some signs and symptoms to watch out for: Fast heartbeat. Classification of Hypoglycemia in Diabetes ( 25, 26) Level. ICD-10-CM Diagnosis Code E11. This is common amongst persons who have type 1 diabetes, with an annual incidence of severe hypoglycemia ranging from 3. ICD-10-C Codes fo Diaetes-esi DiagnosesICD-10 Code With other skin complications E10. code for adverse effect, if applicable, to identify drug ( T36-T50 with fifth or sixth character 5) therapeutic misadventure T38. Y0149_UM011EN_109152022_C 225 W. 649 ICD-10 code E10. Repeated episodes of hypoglycemia result in impaired awareness of subsequent hypoglycemic events, inducing a vicious feed-forward cycle and increasing the risk of morbidity and mortality. Hypoglycemia is a common occurrence in people with diabetes and most frequently it is the result of pharmacologic intervention. Codes; Modifiers; License Data Files; Disclaimer; Search Results. 2 [convert to ICD-9-CM] Hypoglycemia, unspecifiedOne of the goals of ICD-10 is to better characterize the control of people with diabetes and the specifics of the complications that they are experiencing. 1. Get Permissions. The 2024 edition of ICD-10-CM E13. 641 with coma, E11. 2 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 251. Hypoglycemia (low blood sugar); Hypoglycemia post gi surgery; Hypoglycemia unawareness; Hypoglycemic encephalopathy; Loss of hypoglycemic warning; Post gastrointestinal tract surgery hypoglycemia; diabetes with hypoglycemia (E08. Acute hypoglycemia in patients with diabetes can lead to confusion, loss of consciousness, seizures, and even death, but how a particular patient responds to a drop in glucose appears to depend on how frequently that patient experiences hypoglycemia. 500 results found. ICD-10-CM Guideline: Use additional code to identify site and severity of ulcer. The body and brain no longer. 500 results found. S. 95 kg/m 2, and five men, 33. Diabetes diagnosis was identified as an ICD-9 250. Symptoms of hypoglycemia also may occur with higher blood glucose levels, especially if a rapid decrease in blood glucose has occurred (Szadkowska,. 339 was considered to indicate high-risk driving behavior . 641 With hypoglycemia without coma or with hypoglycemia unawareness E10. Familial isolated glucocorticoid deficiency is an adrenocortical failure characterized by very low levels of plasma cortisol despite high levels of plasma adrenocorticotropin (ACTH). This review summarizes the. This article provides key updates for ICD-10 coding for diabetes and its complications. A 'billable code' is detailed enough to be used to specify a medical diagnosis. Type 1 diabetes. ICD-10-CM Diagnosis Code E11. 500 results found. Insulin is a hormone that signals cells to take up sugar from the blood, thus lowering blood sugar. doi: 10. This activity outlines the evaluation,. When it’s untreated, severe hypoglycemia can lead to coma and death. Background. Cite. 649,. 2 [convert to ICD-9-CM] Hypoglycemia, unspecified. PMC6692713. such as hypoglycemia unawareness, long duration of diabetes, strict glycemic control, older age, multiple comorbidities,. Figure 2. Loss of hypo awareness can be troubling, and at times dangerous, so taking steps to regain awareness of your hypo warning signs is. Even though it is not straightforward to set a single glucose level for defining hypoglycemia because glycemic thresholds for symptoms of hypoglycemia (and glucose counterregulation) are affected by the prevailing plasma glucose levels with the result of shifting to lower plasma glucose concentrations after recent antecedent hypoglycemia. 641Impaired awareness of hypoglycemia (IAH) is a reduction in the ability to recognize low blood glucose levels that would otherwise prompt an appropriate corrective therapy. At this level, you need to take action to bring it back up. The 2024 edition of ICD-10-CM E15 became effective on October 1, 2023. In the ICD-10 categories for diabetes (E10–E14), subdivision E1x. Dizziness or lightheadedness. E11. The symptoms of Whipple's triad have been used to describe hypoglycemia since 1938. E10. 500 results found. A. Email Mary. Search Results. Purpose of review: The Roux-en-Y gastric bypass surgery (RYGB) improves glucose control in majority of patients with type 2 diabetes. Hypoglycemia unawareness (HU) is defined at the beginning of neuroglycopenia prior to the appearance of autonomic warning symptoms. Hypoglycemia is defined as a clinical condition when the venous blood glucose level is <55mg/dl (<3mmol/L), obtained if possible, at the time of the symptoms. 2% ± 0. 500 results found. xx). Use Additional. The Hypoglycemia Assessment Tool study in Brazil aimed to determine the proportion of patients experiencing hypoglycemic events and to characterize patient awareness and. The goal of this review is to identify underlying mechanisms by which RYGB cause hypoglycemia and describe. It causes recurrent symptomatic and sometimes, at least temporally, disabling episodes in most people with type 1 diabetes, as well as in many with advanced type 2 diabetes. Hyperinsulinism; Hyperinsulinism, iatrogenic; Hyperplasia of pancreatic islet beta cell; Hypoglycemia (low blood sugar), reactive; Iatrogenic hyperinsulinism. 628 With periodontal disease E10. This is the American ICD-10-CM version of R40. If your blood sugar drops below the healthy range, it causes certain symptoms like shakiness and a faster heartbeat and can be life-threatening if it goes too low. congenital hiatus hernia (. 500 results found. g. Unawareness of hypoglycemia in type 1 diabetes mellitus; ICD-10-CM E10. Oth. Research has shown that hypoglycemia unawareness can reversed, in other words, people can become aware again of low blood sugars. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code. It is one of the most common types of hypoglycemia seen in emergency departments and hospitals. 30 While this study included only people with impaired hypoglycemia awareness, it was powered to test the impact of one. Hypoglycemia remains a major barrier to the achievement of target levels of glycemic control for most individuals with insulin-dependent type 1 diabetes (T1D). 11 Hypoglycemia unawareness or one or more episodes of level 3 hypoglycemia should trigger reevaluation of the treatment regimen. People with hypoglycemia unawareness are not able to tell when their blood sugar. Acute hypoglycaemia stimulates a stress response that. In people with diabetes. If you have hypoglycemia unawareness, you might develop these symptoms at dangerous times, like while driving or operating machinery, which could cause a serious accident. 649, E10. 4 mmol/L. Hypoglycemia is common in diabetes. 64X 6th character required: E11. Other potential causes for low blood sugar that occurs during the day or at night include: hot or humid weather. Very little is known about the impact of hypoglycemia unawareness on regional brain responses; however, these findings would be consistent with the blunted symptom scores as well as the blunted counterregulatory hormone responses to hypoglycemia observed in the T1DM-Unaware group. But if it goes below the healthy range and is not treated, it can get dangerous. , eat) to abort the episode. ICD-10-CM Code for Type 1 diabetes mellitus with hypoglycemia without coma E10. 10 Tabel 2. Hypoglycemia is often defined by a plasma glucose concentration below 70 mg/dL; however, signs and symptoms may not occur until plasma glucose concentrations drop below 55 mg/dL. 649 [convert to ICD-9-CM] Type 1 diabetes mellitus with hypoglycemia without coma. 638. Hypo Unawareness. ICD-10-CM Diagnosis Code E16. Glycemic criteria. Hypoglycemia, occurring after bariatric and other forms of upper gastrointestinal surgery, is increasingly encountered by clinical endocrinologists. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. People with hypoglycemia unawareness are not able to tell when their blood sugar goes too low and may need help from someone else to treat it – this is also known as a severe low. 0 [convert to ICD-9-CM] Drug-induced hypoglycemia without coma. Eleven (26%) of the patients were. Evidence-Based Diabetes Management May 2014. Shock. Background Hyperkalemia can lead to fatal cardiac arrhythmias. Medical authors have astutely noted that hypoglycemia is “the limiting factor” in the treatment of diabetes. Recheck your blood sugar level. Methods: Participants with type 1 diabetes mellitus (type 1 diabetes) were prospectively assessed for hypoglycemia awareness using the Pedersen-Bjergaard. 65: With hyperglycemia E10. Other transitory neonatal endocrine disorders. 4 - other international versions of ICD-10 R40. This concept is important not only in physiology, but also to define the safe glycaemic targets for intensive therapy of Type 1 diabetes. Hypoglycemia remains a limiting factor in the optimal treatment of type 1 diabetes (T1D). ICD-10-CM Diagnosis Code M02. 2. Blood sugar levels change often during the day. doi: 10. unrecognized hypoglycemia can progress to severe symp-toms such as hypoglycemia unawareness, loss of conscious-ness, seizures, coma, and even death [9]. Although hypoglycemia-associated autonomic failure has been studied extensively, little is known about the mechanisms underlying hypoglycemia awareness/unawareness. The prevention or correction of hypoglycemia normally involves both dissipation of insulin and activation of glucose counterregulatory systems. The driver with type 1 diabetes is obliged to check their blood glucose before driving. Those attempting to improve or maintain glycemic control suffer untold numbers of episodes of asymptomatic hypoglycemia; plasma glucose levels may be less than 50–60 mg/dl (2. The concept of hypoglycemia-associated autonomic failure (HAAF) in diabetes posits that recent antecedent hypoglycemia, as well as sleep or prior exercise, causes both defective glucose counterregulation (by attenuating the adrenomedullary epinephrine response, in the setting of absent insulin and glucagon responses) and hypoglycemia. Introduction. His hypoglycemia resolved within a day of treatment with steroids. Diabetic shock, also known as insulin shock or hypoglycemic shock, occurs when a person’s blood sugar drops extremely low. 3,4 Abnormal glucose counterregulation (and hypoglycemia. 2 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 251. The glucose level at which an individual becomes symptomatic is highly. It carries a sixfold increase in risk of severe hypoglycemia episodes, which are associated with confusion, coma, and seizure and which individuals. 3. 82 [convert to ICD-9-CM] Herpes simplex myelitis. 174 results found. v12. The physician’s duty is to familiarize the patient with the risk of hypoglycemia. 649 [convert to ICD-9-CM] Type 2 diabetes mellitus with hypoglycemia without coma. Recurrent hypoglycemia can cause impaired awareness of hypoglycemia (IAH), and increase the risk for severe hypoglycemia. Hypoglycemia Unawareness. 006) and at their last visit (P = 0. , soon translated into use of more physiological replacement of basal insulin (CSII and the nearly peakless LA-IA as compared with NPH) to reduce risk of nocturnal hypoglycemia while. In type 1 diabetes, the pancreas does not produce insulin. This is the American ICD-10-CM version of Q79. Most codes for diabetes will require four or five digits to provide the level of detail required by ICD-10 . Type 2 diabetes mellitus with hypoglycemia without coma. ICD-10 Diagnosis Codes must accompany the claim: E10. Hypoglycemic episodes are a frequent complication in type 1 diabetes, as a result of the long-term effort to maintain glucose levels within the euglycemic range (). This is the American ICD-10-CM version of E11. Increase frequency of glucose monitoring with changes to:insulin dosage, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with renal or hepatic impairment and hypoglycemia unawareness. ICD-10-CM Codes. ICD-10-CM Diagnosis Code E11. Diabetes mellitus type 2 w complications; Diabetes type 2 with hypoglycemia; Diabetes type 2 with hypoglycemia unawareness; Hypoglycemia due to type 2 diabetes mellitus; Insulin. We did not have similarly detailed or validated data regarding outpatient visits (e. Median diabetes duration did not differ between patients with and without hypoglycemia unawareness (26 vs. The following tips may be helpful: 1. The following code (s) above E11. O99. Hypoglycemia is a clinical situation characterized by a reduction in plasma glucose concentration to a level that may induce symptoms or signs such as altered mental status and/or sympathetic nervous system stimulation. 9 The potential mechanisms of chronic hypoglycemia unawareness, hypoglycemia-associated autonomic failure and. Diabetes mellitus. SDI Productions/Getty Images. 810 - other international versions of ICD-10 O99. Download Table | ICD-10 codes for hypoglycemia and underlying diseases. FGM using the Freestyle Libre system revealed hypoglycemia lasting almost 24 hours with evident hypoglycemia unawareness (Fig. Type 1 diabetes. 641 [convert to ICD-9-CM] Type 2 diabetes mellitus with hypoglycemia with coma. 2 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 251. 5 Hypoglycemia is a potential adverse effect of diabetes treatment, induced either by excess exogenous insulin or by excess. have had diabetes for a long time and have always tended to have lots of hypos. E13. 618 [convert to ICD-9-CM] Type 2 diabetes mellitus with other diabetic arthropathy. 8X code when they are hypoglycemic, but what about pts with Hypoglycemic Unawareness which is different than being Hyopglycemic? I struggle with how to code this. Obviously, life-threatening episodes of. Patients with impaired awareness of hypoglycemia had an earlier onset of diabetes (P < 0. Hypoglycemia is increasingly recognized after gastric bypass. ICD-10-CM Coding Rules. The major risk factors for severe hypoglycemia in people with type 1 diabetes include a prior episode of severe hypoglycemia , current low glycated hemoglobin (A1C) (<6. Short description: Hypoglycemia NOS. 618 [convert to ICD-9-CM] Type 2 diabetes mellitus with other diabetic arthropathy. Review the pathophysiology of non-diabetic hypoglycemia. Taken together, even these data suggest that there is some overlap between the features of autonomic neuropathy and hypoglycemic unawareness. Her medical history included atrial fibrillation, hypertension, chronic constipation, and chronic low back pain. Factitious hypoglycemia is the intentional attempt to induce low blood glucose levels and remains one of the diagnostic challenges that face endocrinologists during their practice. Over time, repeated episodes of hypoglycemia can lead to hypoglycemia unawareness. Feeling irritable or confused. 64. Hypoglycemia: May be life-threatening. Hypoglycemia is defined as a clinical condition when the venous blood glucose level is <55mg/dl (<3mmol/L), obtained if possible, at the time of the symptoms. Other specified diabetes mellitus with. Recent revisions of hypoglycemia definitions also include glucose levels <54 mg/dL (i. Around 25% of people with T2D taking insulin for >5 years were found to have severe hypoglycemic events, which is comparable to the severe hypoglycemia rate in adults with type 1 diabetes (T1D) diagnosed within 5 years. 3% to 13. CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description;. It is a major. Hypoglycemic unawareness, defined as hypoglycemia-associated autonomic failure (HAAF), is known to increases the risk of severe hypoglycemia . As most patients are unable to maintain glycemic control on monotherapy, fortunately, effective. A Cox proportional hazards regression model and Cox model coefficients were used to derive a risk scoring system, and 14 predictive variables were selected. xxxx on the active problem list. Hypoglycaemia (blood glucose concentration below the normal range) has been recognised as a complication of insulin treatment from the very first days of the discovery of insulin, and remains a major concern for people with diabetes, their families and healthcare professionals today. V. Severe symptoms typically occur when the blood sugar is less than 40 mg/dL. Persistent mood disorder. 65 With other specified complication E10. 3 kg/m 2) were recruited. It is often the limiting factor in attempts to achieve euglycemia. 539. 42-) ICD-10-CM Diagnosis Code P72. 64 contain annotation back-references that may be applicable to E11. (ICD), ICD-9 of 428. Hypoglycemia remains a limiting factor in the optimal treatment of type 1 diabetes (T1D). code for adverse effect, if applicable, to identify drug ( T36-T50 with fifth or sixth. Seizure. 12. This is called hypoglycemia unawareness. 001), and had lower mean levels of A1C since diabetes onset (P = 0. 649 is a billable diagnosis code used to specify a medical diagnosis of type 1 diabetes mellitus with hypoglycemia without coma. 628 With periodontal disease E10. E15 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Here are some foods that will provide about 15 grams of carbohydrate to lower blood sugar: eat three glucose tablets or four dextrose tablets. 1,2 Severe hypoglycemia, resulting in neuroglycopenic symptoms requiring assistance from another person, is associated with significant morbidity including vascular events, falls, cognitive impairment, and death. Furthermore, iatrogenic hypoglycemia precl. in 1991 as the inability to recognize autonomic warning symptoms or the failure to develop them before the onset of neurogenic hypoglycemia. 3) • Hypoglycemia Due to Medication Errors: Accidental mix-ups. Issue SP8. To make sense of the coding descriptions, the authors will explain them based on the way one might approach diabetes clinically. K. Clinically significant hypoglycemia (level 2)Identification of patients with risk factors for severe hypoglycemia is a critical step in the prevention of hypoglycemia. To assess the characteristics of patients with hypoglycemia unawareness (development of neuroglycopenia without appropriate prior autonomic warning symptoms) and its predisposing factors. 649 - Type 2 diabetes mellitus with hypoglycemia without coma. i12. ICD-10-CM E88. 649 ICD-10 code E11. Summarize the. 641 with coma, E11. Hypoglycemia (hypoglycaemia in British English) is the medical term for a pathologic state produced by a lower than normal level of glucose in the blood. E16. Documentation of a blood glucose <60 mg/dL with accompanying symptoms is crucial to diagnosing clinically significant hypoglycemia. The major counter-regulatory hormone that causes glucose to be released by the liver to raise blood sugar. Oth. 87. ( 4) The coding system was updated in October 2015 to its 10th revision because it was thought that the 9th revision (ICD-9) no longer. 64 : E00-E89. Short description: DMII oth nt st uncntrld. Glucagon—a hormone that stimulates the liver to release glucose that is stored in the bloodstream—can be given to help with severe symptoms. Unfortunately, intensive glycemic control often results in insulin-induced hypoglycemia. 649); code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) ICD-10-CM Diagnosis Code E08. Objective People with type 2 diabetes on insulin are at risk for hypoglycemia. 630 With other oral complications E10. It causes recurrent symptomatic and sometimes, at least temporally, disabling episodes in most people with type 1 diabetes, as well as in many with advanced type 2 diabetes. Factors regulating the magnitude of hypoglycemia associated. 649 for Type 1 diabetes mellitus with hypoglycemia without coma is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases . Decreased or impaired awareness of hypoglycemia, commonly referred to as HU, is the development of neuroglycopenic symptoms without first having autonomic. Showing 1-25: ICD-10-CM Diagnosis Code E10. The rates of any type of hypoglycemia are ∼50. Hypoglycemia can also cause emotional symptoms such as irritability or, in some cases, giddiness. Due to anticipated differential use of carvedilol vs. 6. Type 1 diabetes w diabetic peripheral angiopath w/o gangrene; Diabetes type 1 with peripheral vascular disease; Diabetes type 1 with small vessel disease; Peripheral angiopathy due to type 1 diabetes mellitus. An 85-year-old woman called an emergency medical service (EMS) for hematochezia. ICD-10-CM Diagnosis Code E66. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). This is the American ICD-10-CM version of E88. 7 episodes per patient per year ( 1 ). 14 Insulin-treated patients with hypoglycemia unawareness, one level 3 hypoglycemic event, or a pattern of unexplained level 2 hypoglycemia should be advised to raise their glycemic targets to strictly avoid hypoglycemia for at least several weeks in order to partially reverse hypoglycemia unawareness and reduce risk of future episodes. Because activation of the autonomic nervous system is a fundamental physiological response to hypoglycemia and provokes many of the symptoms of hypoglycemia, autonomic neuropathy was considered to be a cause of IAH for many years (). ICD-10-PCS; New 2024 Codes; Codes Revised in 2024; Codes Deleted in 2024; HCPCS . 649,. 641 [convert to ICD-9-CM] Other specified diabetes mellitus with hypoglycemia with coma. 618 [convert to ICD-9-CM] Type 2 diabetes mellitus with other diabetic arthropathy. This chapter includes symptoms, signs, abnormal. 2 [convert to ICD-9-CM] Hypoglycemia, unspecified. 10–250. Showing 1-25: ICD-10-CM Diagnosis Code E11. 6. ICD-10-CM E88. ICD-10-CM Diagnosis Code E11. When it’s untreated, severe hypoglycemia can lead to coma and death. 001), were younger (P < 0. Severe hypoglycemia may cause: Unresponsiveness (loss of consciousness) Seizures. When this happens, the risk of severe, life-threatening hypoglycemia increases. The 2024 edition of ICD-10-CM Q79. Whether use of a hybrid. Marks, in Encyclopedia of Human Nutrition (Second Edition), 2005 Definition. Hypoglycemia unawareness and hypoglycemia-associated autonomic failure. Nondiabetic hypoglycemic coma. Background Hypoglycemia affects patient safety and glycemic control during insulin treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). 64 became effective on October 1, 2023. A workup for hypoglycemia should be initiated if the patient fulfills Whipple’s triad; biochemical evidence of. m. 810 may differ. Hypoglycemia; Hypoglycemia (low blood sugar); Hypoglycemia post gi surgery; Hypoglycemia unawareness; Hypoglycemic encephalopathy; Loss of hypoglycemic warning; Post gastrointestinal tract surgery hypoglycemia; diabetes with hypoglycemia (E08. xx or ICD-10 of. [Billable] There's more to see -- the rest of this topic is available only to subscribers. doi: 10. This is the American ICD-10-CM version of E10. Slurred speech. Older adults with T2D are at high risk of recurring hypoglycemia, a condition associated with marked morbidity and mortality, because their counter-regulatory mechanism to hypoglycemia is attenuated, and recurring hypoglycemic episodes can lead to hypoglycemia unawareness. 3213 [convert to ICD-9-CM] Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral. PBH, including unawareness PBH, remained very common and persisted after more than five years in average following BS. Because many people with diabetes demonstrate impaired counterregulatory responses to hypoglycemia and/or experience hypoglycemia unawareness, a. Type 1 Excludes. 810 became effective on October 1, 2023. xx or ICD-10 E08-13. Risks of Hypoglycemia With Type 1 Diabetes. 2B), with a small improvement in hypoglycemia compared with control appearing when using a progressively lower threshold below 3. 69 Type 1 diabetes mellitus with other specified complication; E10. 81 may differ. 8–2. 9 may differ. Another risk factor is the presence of hypoglycemia unawareness leading to an inability to recognize symptoms of hypoglycemia. Predictors were previous severe hypoglycemia and impaired hypoglycemia awareness or unawareness. Early warning signs and symptoms. Hypoglycemia* E10. The glucose level at which an individual becomes symptomatic is highly. This occurs when blood glucose levels fall below 70 mg/dl. 1397. 500 results found. 1 ± 0. ICD-9-CM 251. 641. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). 13 Insulin-treated patients with hypoglycemia unawareness, one level 3 hypoglycemic event, or a pattern of unexplained level 2 hypoglycemia should be advised to raise their glycemic targets to strictly avoid hypoglycemia for at least several weeks in order to partially reverse hypoglycemia unawareness and reduce risk of future episodes. Hypoglycemia is in many ways the Achilles' heel of diabetes treatment. #1. Hypo unawareness is when you can’t spot the signs you're going hypo.