ICD-10-CM requires very specific details regarding anycomplications or manifestation of the diabetes. For example,code E08.341 denotes diabetes mellitus due to underlyingcondition with severe non-proliferative diabetic retinopathywith macular edema. ICD-10-CM code I10 denotes essential (primary)hypertension.
· Always query if the physician’s documentation seems unclear, but based on the information given, I would report the following ICD-10-CM codes for this patient’s encounter: E11.649, Type 2 diabetes mellitus with hypoglycemia without coma G93.41, metabolic encephalopathy E11.22, Type 2 diabetes ...
· Secondary Diagnosis: Both ICD-9-CM code 403.90 / ICD-10-CM code I12.9 have the same guidelines pertaining with Hypertension associated with Chronic Kidney Disease. As per the chapter specific guideline; both ICD-9-CM and ICD-10-CM presume a cause-and-effect relationship and classifies Chronic Kidney Disease with hypertension as Hypertensive Chronic Kidney …
ICD-10-CM Diagnosis Codes E08-*. E08 Diabetes mellitus due to underlying condition... E08.0 Diabetes mellitus due to underlying condition... E08.00 Diabetes mellitus due to underlying …
Hypertensive heart disease NOS. ICD-10-CM Diagnosis Code E08.3213 [convert to ICD-9-CM] Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy …
E11. 22 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
E08. 1 Diabetes mellitus due to underlying condition... E08. 10 Diabetes mellitus due to underlying condition...
ICD-10 uses only a single code for individuals who meet criteria for hypertension and do not have comorbid heart or kidney disease. That code is I10, Essential (primary) hypertension.
ICD-10 code: E11. 22 Type 2 diabetes mellitus With renal complications With other multiple complications, controlled.
Type 2 diabetes mellitus without complications E11. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM E11. 9 became effective on October 1, 2021.
ICD-Code E11* is a non-billable ICD-10 code used for healthcare diagnosis reimbursement of Type 2 Diabetes Mellitus. Its corresponding ICD-9 code is 250. Code I10 is the diagnosis code used for Type 2 Diabetes Mellitus.
The incorrect portion of the response came as an aside at the end, where it was stated that “it would be redundant to assign codes for both diabetic nephropathy (E11. 21) and diabetic chronic kidney disease (E11. 22), as diabetic chronic kidney disease is a more specific condition.”
Code N18. 6, end-stage renal disease, is to be reported for CKD that requires chronic dialysis. relationship between diabetes and CKD when both conditions are documented in the medical record.
N18. 32- Chronic Kidney Disease- stage 3b.
Table 5ICD-9-CM diagnosis codes defining diabetesDescriptionICD-9-CM codeDiabetes mellitus without mention of complications250.0xDiabetes with ketoacidosis250.1xDiabetes with hyperosmolarity250.2xDiabetes with other coma250.3x8 more rows
ICD-10 Code Z79. 4, Long-term (current) use of insulin should be assigned to indicate that the patient uses insulin for Type 2 diabetes mellitus (Category E11* codes). Z79.
Table 1: HCPCS/CPT Codes and DescriptorsHCPCS/CPT CodesCode Descriptors82947Glucose; quantitative, blood (except reagent strip)82950Glucose; post glucose dose (includes glucose)82951Glucose Tolerance Test (GTT); three specimens (includes glucose)83036Hemoglobin A1C
Type 2 diabetes is a chronic disease. It is characterized by high levels of sugar in the blood. Type 2 diabetes is also called type 2 diabetes mellitus and adult-onset diabetes. That's because it used to start almost always in middle- and late-adulthood.
Therefore, one occurrence of an elevated blood pressure reading is not usually diagnosed as hypertension. ICD-9-CM code 796.2 is assigned for elevated blood pressure without a diagnosis of HTN and also for transient or borderline hypertension. Look at the hypertension table in the index. Once the diagnosis of HTN is established by a provider, a code from category 401 is assigned, with a fourth digit required: 0 for malignant, 1 for benign, and 9 for unspecified. ** Do not assign a code for benign or malignant HTN unless it is specifically documented by a physician. Continue reading >>
It has many different causes including endocrine diseases, kidney diseases, and tumors. It also can be a side effect of many medications. Types Renal/Kidney Renovascular hypertension (I15.0) It has two main causes: fibromuscular dysplasia and atheromatous stenosis. Also diabetes See main article at Renovascular hypertension. Kidney Other well known causes include diseases of the kidney. This includes diseases such as polycystic kidney disease which is a cystic genetic disorder of the kidneys, PKD ,which is characterized by the presence of multiple cysts (hence, "polycystic") in both kidneys, can also damage the liver, pancreas, and rarely, the heart and brain. [1] [2] [3] [4] It can be autosomal dominant or autosomal recessive, with the autosomal dominant form being more common and characterized by progressive cyst development and bilaterally enlarged kidneys with multiple cysts, with concurrent development of hypertension, renal insufficiency and renal pain. [5] Or chronic glomerulonephritis which is a disease characterized by inflammation of the glomeruli, or small blood vessels in the kidneys. [6] [7] [8] Hypertension can also be produced by diseases of the renal arteries supplying the kidney. This is known as renovascular hypertension; it is thought that decreased perfusion of renal tissue due to stenosis of a main or branch renal artery activates the renin-angiotensin system. [9] [10] [11] Also, some renal tumors can cause hypertension. The differential diagnosis of a Continue reading >>
The 2018 ICD-10-CM Official Guidelines for Coding and Reporting includes a dozen substantive changes in Section I, and one important change in Section II. Here are those changes. 1. Information has been added to clarify the meaning of with (new text is bold): The word with or in should be interpreted to mean associated with or due to when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The classification presumes a causal relationship between the two conditions linked by these terms in the Alphabetic Index or Tabular List. These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated or when another guideline exists that specifically requires a documented linkage between two conditions (e.g., sepsis guideline for acute organ dysfunction that is not clearly associated with the sepsis). For conditions not specifically linked by these relational terms in the classification or when a guideline requires that a linkage between two conditions be explicitly documented, provider documentation must link the conditions to code them as related. 2. Code also guidelines are clarified. When two codes may be required to fully describe a condition, a code also note is indicated. The note does not provide sequencing direction. The new guidelines explain, The sequencing depends on the circumstances of the encounter. 3. Information is added for brachytherapy, within admissions/encounters involving chemotherapy, immunotherapy, and radiation therapy: If a patient admission/encounter is s Continue reading >>
Correct Answer from January Case Scenario Principal Diagnosis: Although the patient came in to ER for suspected gallstone pancreatitis, the main reason for the patients admission to the hospital and the need for surgery were the gall stones and the bile duct stones. Hence our principal diagnosis is 574.71 (ICD-9-CM), K80.65 (ICD-10-CM). As per ICD-9-CM and ICD-10-CM Coding Guideline Section II.J Admission from Outpatient Surgery: When a patient receives surgery in the hospitals outpatient surgery department and is subsequently admitted for continuing inpatient care at the same hospital, the following guidelines should be followed in selecting the principal diagnosis for inpatient admission: If the reason for the inpatient admission is a complication, assign the complication as the principal diagnosis. If no complication, or other condition, is documented as the reason for the inpatient admission, assign the reason for the outpatient surgery as principal diagnosis. If the reason for the inpatient admission is another condition unrelated to the surgery, assign the unrelated condition as the principal diagnosis. Secondary Diagnosis: Both ICD-9-CM code 403.90 / ICD-10-CM code I12.9 have the same guidelines pertaining with Hypertension associated with Chronic Kidney Disease. As per the chapter specific guideline; both ICD-9-CM and ICD-10-CM presume a cause-and-effect relationship and classifies Chronic Kidney Disease with hypertension as Hypertensive Chronic Kidney Diseases. Both ICD-9-CM and ICD-10-CM pointed out that if the type of Diabetes is not documented in the medical record, the default is Type II. In addition, as per Coding Clinic, Fourth Quarter 2004, Pages 53 to 56: Effective October 1, 2004, changes have been made to the fifth digits applicable to category 250, Continue reading >>
How often is it covered? Medicare Part B (Medical Insurance) covers screenings to check for diabetes. You may be eligible for 2 diabetes screenings each year. Who's eligible? Part B covers these screenings if your doctor determines you're at risk for diabetes or you're diagnosed with pre-diabetes. These lab tests are covered if you have any of these risk factors: High blood pressure (hypertension) History of abnormal cholesterol and triglyceride levels (dyslipidemia) Obesity History of high blood sugar (glucose) Part B also covers these tests if 2 or more of these apply to you: Age 65 or older Overweight Family history of diabetes (parents, brothers, sisters) History of gestational diabetes (diabetes during pregnancy) or delivery of a baby weighing more than 9 pounds Your costs in Original Medicare You pay nothing for these tests if your doctor or other qualified health care provider accepts assignment. Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them. Continue reading >>
Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
I would code it as I10 for hypertension and E11.9 for diabetes.
Per our recent Humana audit, it was indicated that diabetes and hypertension have an assumed relationship and it should be coded as E11.59 (for type 2 diabetic.) We did not code them this way and got dinged every visit they audited for us coding I10 and E11.9. I disagreed with the lady, but they are then ones doing the auditing....
If the provider has specifically documented that the hypertension was caused by the diabetes, then you would code the hypertension as a circulatory complication. Only the terms listed in the index under "diabetes with" should be coded as a complication with specific documentation linking them. See the instructional note in Section I, part A - Conventions for the ICD-10-CM:
Diabetes and hypertension are not presumed to be related unless the provider specifically documents that it is.
we should code diabetes-E11.9 and hypertension-I10 separately. Diabetes is not always associated with hypertension, We should read provider documentation clearly and code it accordingly.
As I understand the guidelines, if the provider has only documented "diabetes with hypertension", then you would not presume a causal relationship between the two because the two terms "diabetes" and "hypertension" are not linked in ICD-10 by the term "with". If the provider has specifically documented that the hypertension was caused by the diabetes, then you would code the hypertension as a circulatory complication. Only the terms listed in the index under "diabetes with" should be coded as a complication with specific documentation linking them. See the instructional note in Section I, part A - Conventions for the ICD-10-CM:#N#The word “with” or “in” should be interpreted to mean “associated with” or “due to” when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The classification presumes a causal relationship between the two conditions linked by these terms in the Alphabetic Index or Tabular List. These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated....For conditions not specifically linked by these relational terms in the classification or when a guideline requires that a linkage between two conditions be explicitly documented, provider documentation must link the conditions in order to code them as related.
The ICD-10 guidance is that a causal relationship is presumed when the word 'with' appears in the ICD-10 alphabetic index or tabular list, not when it appears in the medical record. So I would not presume a relationship from the documentation example you give here. 'Associated with' should not be assumed to mean 'caused by', and neither hyperlipidemia nor atherosclerosis are linked to diabetes in ICD-10.
Report code I10 for hypertension and the appropriate E11.-code for Type 2 diabetes with any documented manifestations. If a causal relationship exists between the two conditions, they still must be coded separately because ICD-10 does not presume a linkage between hypertension and diabetes as it does with some other conditions. To report hypertension as a complication of diabetes, submit I15.2, “Hypertension secondary to endocrine disorders” and E11.-for diabetes, and include a statement in the physician's note indicating the diabetes is the cause of the hypertension.
Medicare requires that the physician who is comprehensively treating the patient's diabetes must certify his or her eligibility for diabetic shoes or inserts. The patient must have one or more of the following conditions in one or both feet: 1 Previous partial or complete foot amputation, 2 History of foot ulceration, 3 History of preulcerative calluses, 4 Peripheral neuropathy with evidence of callus formation, 5 Foot deformity, 6 Poor circulation.
To report hypertension as a complication of diabetes, submit I15.2, “Hypertension secondary to endocrine disorders” and E11.-for diabetes, and include a statement in the physician's note indicating the diabetes is the cause of the hypertension.
Medicare requires that the physician who is comprehensively treating the patient's diabetes must certify his or her eligibility for diabetic shoes or inserts. The patient must have one or more of the following conditions in one or both feet: Previous partial or complete foot amputation,