Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > General Discussion
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 08-29-2008, 09:52 AM
heatherwinters heatherwinters is offline
Expert
 
Join Date: Apr 2007
Location: Malone
Posts: 358
heatherwinters is on a distinguished road
Default 790.21 vs. 790.6 Elevated Fasting Glucose and Medicare

ICD-9-CM Official Guidelines for Coding and Reporting I would like some feedback from other coders about how they would code a dx of elevated glucose as indicated by a lab value of >90 as part of a CMP. In the past, I have coded these as 790.21 in absence of a dx of DM, however, the following seems to lean towards 790.6. Any thoughts on this?



Medicare National Coverage
Determinations (NCD)
Coding Policy Manual and Change Report
July 2008


190.20 – Blood Glucose Testing
1. A diagnostic statement of impaired glucose tolerance must be evaluated in the context of the documentation in the medical record in order to assign the most accurate ICD-9-CM code. An abnormally elevated fasting blood glucose level in the absence of the diagnosis of diabetes is classified to Code 790.6 - other abnormal blood chemistry. If the provider bases the diagnostic statement of impaired glucose tolerance” on an abnormal glucose tolerance test, the condition is classified to 790.2 -- normal glucose tolerance test. Both conditions are considered indications for ordering glycated hemoglobin or glycated protein testing in the absence of the diagnosis of diabetes mellitus.
__________________
Heather Winters, CPC, CFPC
Reply With Quote
  #2  
Old 08-29-2008, 10:35 AM
dmaec's Avatar
dmaec dmaec is offline
True Blue
 
Join Date: Apr 2007
Location: Duluth, Minnesota
Posts: 1,134
dmaec is on a distinguished road
Default

If the dx is for elevated or abnormal glucose - I code 790.29
If it's for impaired fasting glucose I code - 790.21
but, apparently from what you wrote, I shouldn't code the 790.21 for impaired fasting glucose UNLESS they have a dx of DM. I'll have to keep my eye out for that when it comes through!
{that's my opinion on the posted matter}
__________________
Donna, CPC, CPC-H
Reply With Quote
  #3  
Old 08-29-2008, 02:22 PM
FTessaBartels FTessaBartels is offline
True Blue
 
Join Date: Apr 2007
Location: Milwaukee WI
Posts: 4,436
FTessaBartels will become famous soon enough
Default The way I read it ...

Don't you just love when bureaucrats try to write a definitive statement?

Okay, let's tear this apart and try to figure out what they are saying ...

"An abnormally elevated fasting blood glucose level in the absence of the diagnosis of diabetes is classified to Code 790.6 - other abnormal blood chemistry." Seems clear enough ... if there is no dx of DM, you use 790.6

BUT ..."If the provider bases the diagnostic statement of impaired glucose tolerance on an abnormal glucose tolerance test, the condition is classified to 790.2 -- normal glucose tolerance test." ... so, if there is not dx of DM, BUT the provider does have "a diagnostic statement of impaired glucose tolerance," then you use 790.2x (you need a 5th digit) ... so we're back to 790.21.

Seems to use anything other than 790.6 the MD has to at least state there is impaired glucose tolerance. That's my interpretation ...

F Tessa Bartels, CPC, CPC-E/M
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 07:14 AM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC