MDS Alert
What Diagnosis Codes Would You Use For This Scenario?
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Question: Our new resident has hypertension and a blood pressure of 190/115. He also has congestive heart failure (CHF) with peripheral edema. He also has type II diabetes with diabetic peripheral manifestations, peripheral angiopathy and currently uses insulin. And he has a suprapubic catheter and osteoarthritis. How should we code for him? Answer: List the following codes for your resident's diagnoses, but in order to sequence them properly, you'll need to know the focus and complexity of care and treatment being provided. Whatever your sequence may be, you should list the code for diabetes (250.70) and the code for your resident's diabetic manifestation (443.81, Peripheral angiopathy). Because your resident has a type II diabetes, list V58.67 to note his use of insulin. Diabetics with type I diabetes must take insulin, so this code isn't necessary. Source: Charlotte Lefert, RHIA, an independent health information management consultant based in Madison, WI.
--401.9 (Essential hypertension; unspecified);
--428.0 (Congestive heart failure, unspecified);
--782.3 (Edema);
--250.70 (Diabetes with peripheral circulatory disorders; type II or unspecified type, not stated as uncontrolled);
--443.81 (Peripheral angiopathy in diseases classified elsewhere);
--V58.67 (Long-term [current] use of insulin);
--715.90 (Osteoarthrosis, unspecified whether generalized or localized; site unspecified); and
--V55.5 (Attention to artificial openings; cystostomy).
Note: The ICD-9-CM Official Guidelines for Coding and Reporting is updated at least annually but may be changed more frequently. Make sure you are using the most current set of guidelines. Visit the National Centers for Health Statistics Web site to see the most up-to-date guidelines at www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/ftpicd9.htm.
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