diabetes

  1. J

    Quality Measure

    Hi Everyone! Is there a CPT2/HCPCS or any code for that matter that identifies when a referral has been made for a diabetic retinal exam? Or any that we can use under the auspices of diabetes management that we can isolate for a referral for this test?
  2. G

    Can the elements in the diabetes management exam be used as elements for the exam portion for e&m level?

    Diabetes Management Exam: Foot Exam (with socks and/or shoes not present): Inspection: MSK/Extremities? Left foot: normal Right foot: normal Nails: Left foot: normal Right foot: normal Sensory-Pinprick/Light touch: Neuro? Left...
  3. C

    Question Correct coding of PVD, DM, and Arteriosclerosis

    What is the correct coding for DM, PVD, and Arteriosclerosis? Can we code the Arteriosclerosis of extremity with claudication when we see Arteriosclerosis and PVD or would the provider have to specifically state claudication since it’s a symptom?
  4. MeanderingMichigander

    Diabetes with PVD (vs) peripheral angiopathy

    I'm trying to determine if DM2 with peripheral angiopathy without gangrene (E11.51) is the same as (or, actually, is more appropriate coding for) DM2 with perhipheral vascular disease, unspecified (E11.69, I73.9). In researching these and reviewing synonyms, etc., on several different sites, it...
  5. MeanderingMichigander

    Coding presence of insulin pump

    I am struggling to find anything definitive either way... Hoping someone here can point me in the right direction :confused: (The below example assumes that the visit record does support both codes being discussed.) When coding the presence of an insulin pump (Z96.41), do you ALSO need to code...
  6. T

    CKD "likely" due to HTN / ESRD "suspect" DN

    Hello, Need some help from the Pro-fee coders out there.... I'm running into this a lot working in Nephrology. Some providers state in their Assessment & Plan: CKD "likely" due to HTN or ESRD "suspect" DN (Diabetic Nephropathy). Do we still code the causal relationship combo code between...
  7. A

    How to code diagnosis diabetes mellitus with A1C

    I have had 2 different doctors in the past week list their patient's elevated A1C with the diabetes diagnosis. Listed in the Assessment, the doctor wrote as the patient's diagnosis "Diabetes Mellitus, Type II with A1C 8.7". For the 2nd doctor, he wrote the unforgivable..."Uncontrolled...
  8. R

    hypertension due to diabetes

    Hello- i'm trying without much luck to find any guidelines on how to code when a provider documents "hypertension due to diabetes" I know that DM and HTN do not have a causal relationship and there are no combination codes to link them together. One resource (see below) I found says you would...
  9. J

    Diabetic Shoe Measuring

    We have a Nurse that does the measuring for shoes for diabetic patients. Normally, I would charge the A5500 "For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe" but the...
  10. L

    Dm + hf

    An audit showed that DM + HF is assumed as complication of E11.59. Is there info regarding this?
  11. R

    Coding for Diabetes with A1C results

    Hello, I have a question in regards to HCC codes. If a patient comes in and the provider states the patient is there to follow up on the DMII, and the provider documented that the patients' A1c levels are @ a 7.1, can the coder then documented Diabetes Type 2 with Hyperglycemia, or does the...
  12. R

    Gestation diabetes during post partum period

    I am not really familiar with OBGYN, but I have a provider who is coding O24.415 - Gestational diabetes mellitus in pregnancy, controlled by oral hypoglycemic drugs. My issue is that this patient is 7 month postpartum, therefore I believe that this MD should not longer be using the O - code...
  13. N

    Diabetic combination codes

    If you have a diabetic patient who is hypertensive, with stage 3 kidney disease, is the assumption still that the kidney disease is related to the hypertension? If so, would I still bill the diabetes with renal manifestations? Does the provider have to link the chronic kidney disease to the...
  14. V

    Dx of Metabolism vs Pre Diabetes

    Does anyone know the difference between E74.9 (Disorder of Carbohydrate Metabolism) vs R73.03 (PreDiabetes?) Pre-Diabetes is a type of Carbohydrate Metabolism Disorder so when do you know when to use what? I ask because one is considered "risk" code and the other is not.
  15. V

    Dx of Metabolism vs Pre Diabetes

    Does anyone know the difference between E74.9 (Disorder of Carbohydrate Metabolism) vs R73.03 (PreDiabetes?) Pre-Diabetes is a type of Carbohydrate Metabolism Disorder so when do you know when to use what? I ask because one is considered "risk" code and the other is not.
  16. T

    Gestational Diabetes Management

    I am trying to bill out a diabetes management "class" that our provider does once a month for patients that are newly diagnosed with gestational diabetes. She spends about 2 hours with all of the patients at one time and also takes time to document each individual HPI, ROS, Exam & Assesment...
  17. T

    Gestational Diabetes Management

    I am trying to bill out a diabetes management "class" that our provider does once a month for patients that are newly diagnosed with gestational diabetes. She spends about 2 hours with all of the patients at one time and also takes time to document each individual HPI, ROS, Exam & Assesment...
  18. A

    Diabetic/Pressure Ulcer

    Okay so this case got me thinking. The patient is diabetic and in the note the doctor states "new pressure ulcer in the face of diabetes to the right fifth toe". Then later in the assessment he states "Wagner grade 2 diabetic foot ulcer in the face of pressure." Would you just take this to...
  19. R

    Major Diabetes complication confusion!!!

    I am dealing with a lot of debate about when it is ok to code a complication with Diabetes. This is creating A LOT of contention between the providers and coders. Example: Pt comes in for possible Strep. In the HPI it states the Blood sugars are in the 300's and they have DMII with...
  20. B

    ESRD & Diabetes

    I am coding for a dialysis facility, therefore all of my patients have ESRD (N18.6). The majority of my patients also have diabetes, but it is either not documented as to whether diabetes caused the ESRD or the record will state the ESRD was caused by another disorder, but the patient also has...
  21. M

    Uncontrolled Diabetes

    Does anyone know the appropriate code to use for Uncontrolled Diabetes? Much appreciated!!!
  22. YBVON316

    Coding of Type II Diabetes with polyneuropathy

    Info on my idea... if the patient comes in and is diagnosed with diabetic type 2 neuropathy i believe the appropriate code should be E11.42. This is in reading the tabular noes, excludes one notes and the chapter rules and guidance. My reasoning is that excludes 1 note excudes (E08.42) and...
  23. V

    Delivery ICD10 Codes

    How would you code a normal vaginal delivery when the patient had gestational diabetes during the pregnancy?
  24. D

    Documentation Plan of Treatment

    In the assessment, the physician documents DM type II with periph Circ manifestations and peripheral angiopathy in disease and for treatment, he indicates continue with diet and no change. He does not address either in the review of systems or in the PMH, patient is not on meds for either, and...
  25. P

    Diabetes--E11.21 and E11.22

    Codes are physician selected then sent to coding for billing where I work. If E11.21 Diabetes with nephropathy and N18.3 are chosen together, does this mean that E11.22 Diabetes with CKD is also chosen. Chart list CKD as chronic but not mentioned as diab. Tried to speak with physician about...
  26. B

    Diabetes Education as Incident To

    We are a multi specialty practice providing Diabetes Education by RD's. Would you ever bill out DM Education CPT codes 98960, 98961 & 98962 (which are non-physician professional codes) as incident to with the M.D. as the supervising physician?
  27. M

    DM specificity

    If a patient has been diagnosed with 250.60, along with 353.5, when the patient presents for a DM check and management, should the 250.60 be coded or just 250.00? thanks in advance
  28. T

    hyperglycemia and DM

    If Dr documents HYPERglycemia as diagnosis and according to the patients chart, patient has a history of DM - do you code 790.29 and 250.0x or just 250.0x? Thanks
  29. E

    Maturity onset diabetes of the young (MODY)

    Can anyone help me find the ICD-9 code for maturity onset diabetes of the young (MODY)? The entry in Wikipedia says that it is also sometimes called "monogenic diabetes" and that it is not the same thing as Type 2 diabetes in a young person. My Taber's Cyclopedic Medical Dictionary, on the...
  30. A

    HCC coding: 270.7x

    Am currently auditing HCC: 250.70 (DM w/peripheral circulatory disorders). It was linked w/443.9 (PVD NOS) but another "professional source" claims that 250.7x can ONLY be linked w/either 785.4 (gangrene) or 443.81 (peripheral angiopathy) as listed in the book. More often than not, when I have...
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