Primary Care Coding Alert

Question: A patient presents to our family practice for foot care due to diabetes complications. The patient was a diabetic for over 30 years but had a pancreas transplant that rendered him "cured" of the diabetes. The family physician notes that diabetes caused the patient's foot problem, but I'm not sure if I can use diabetes diagnosis codes for a patient who no longer has the disease.

Kansas Subscriber Answer: After living with diabetes for 30 years, a patient may certainly have residual diabetic complications. Although a pancreas transplant normalizes a patient's blood glucose levels and essentially "cures" the diabetes, the transplant won't repair previous damage to the body. So, if your family physician treats a pancreas transplant patient, you should code the patient's diabetic complications with both the diabetes complication code and the specific code for the given condition.

For example, if diabetic peripheral circulatory disorders caused your patient's foot problems, you might report 250.7x. You may also consider assigning a code for the patient's transplant status (V42.83, Organ or tissue replaced by transplant; pancreas). You should not report a basic diabetes code, such as 250.03 (Diabetes mellitus without mention of complication; type I, uncontrolled). Because the patient no longer has diabetes, you should only report the diabetic complications.