Diabetes Mellitus and the Use of Insulin and Oral Hypoglycemic Drugs If the documentation in a medical record does not indicate the type of diabetes but does indicate that the patient uses insulin: Assign code E11-, Type 2 diabetes mellitus. Assign code Z79.4, Long term (current) use of insulin, or Z79.84, Long-term (current) use of oral
Guidelines are part of the process which seeks to address those problems. IDF has produced a series of guidelines on different aspects of diabetes management, prevention and care. Category Diabetes in children Type 2 diabetes Gestational diabetes Diabetes complications Guideline development Diabetes management Diabetes and Ramadan.
Chronic kidney disease is a progressive, non-communicable condition that ... including ageing populations [2][7] and the rising prevalence of commorbidities like diabetes, hypertension and obesity [3]. “Europe is not acting fast enough”, Professor ...
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.)
ICD-10 code I12. 9 for Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease is a medical classification as listed by WHO under the range - Diseases of the circulatory system .
E11. 22 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
It is true you wouldn't code both. Diabetic nephropathy is a specific subset of CKD. It is an advanced renal disease due to microvascular damage from hyperglycemia, manifested by proteinuria.
If hypertension, heart failure and chronic kidney disease are all documented, use a combination code from category I13 — hypertensive heart and chronic kidney disease. These are just a few examples of conditions that have an assumed causal relationship in ICD-10-CM.
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.
Diabetes damages arteries and makes them targets for hardening, called atherosclerosis. That can cause high blood pressure, which if not treated, can lead to trouble including blood vessel damage, heart attack, and kidney failure.
Type 2 diabetes mellitus (T2D) is associated with an increased risk of hypertension, and vice versa, in observational studies. What New Information Does This Article Contribute? T2D may causally affect hypertension, whereas the hypertension→T2D relation is unlikely to be causal.
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.
22 for Type 2 diabetes mellitus with diabetic chronic kidney disease is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases .
CKD is most likely related to both hypertension and diabetes when the patient has all three conditions. Both high blood sugar and high pressure in the blood vessels will cause the vessels to deteriorate, which can then damage the kidneys.
ICD-10-CM Code for Type 2 diabetes mellitus with diabetic nephropathy E11. 21.
In the ICD-10-CM® Official Guidelines Section I.A.15, the "with" convention states that conditions that follow "with" after the main term in the index and/or have "with" in the code title are assumed to be linked unless the provider indicates that they are unrelated . There is also Coding Clinic® guidance that further clarifies this guideline and indicates that there is an assumed link unless the provider says unrelated or states a different cause.
The guideline "with" which again is also stated at the begining of Chapter 9 states that as long as your Index or Description of the code in the tabular list, any of them 2, have the word "with" you can assume the relationship even when the provider doesnt stated .
By stating with in the daignosis of the Diabetes CKD, it does not mean he is linking them and not the hypertension as the guideline states we do not have to link the hypertension and heart involvement. He must specifically state as not due to hypertension.
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:
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.