Primary Care Coding Alert

Question: For patients being treated for diabetic neuropathy, is it necessary to code separately for the manifestations? New Jersey Subscriber Answer: Yes, it is very important to code for the manifestations of diabetes separate from diabetes itself. Oftentimes, the manifestations of diabetes are distinct diseases in themselves although they may have arisen originally due to diabetes. Moreover, their evaluation and management is distinct from that of the primary disease. For example, to establish presence of neuropathy in a diabetic, a different set of competencies (skills in history taking and physical examination) and laboratory tests is required. Once established, treatment for this is also distinct from the treatment for diabetes. Therefore, in order to give the most complete picture of the level of E/M service done, the manifestation code must also be included as the secondary diagnosis. In the scenario above, diabetic neuropathy will be coded as 250.60-337.1: • 250.60 -- Diabetes [...]