Wiki Ckd htn dm type ii

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DeniMCharlotte

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I queried one of my providers recently regarding a patient who had CKD4 and HTN. She wanted to use I10 with N18.4 and I explained due to ICD-10 guidelines that there was a presumed relationship between the two and that I12.9 should be utilized. She then came back and told me that the CKD was due to Diabetes and that she had received that information from the patients Nephrologist. DM was not mentioned in her notes whatsoever, but I told her if the patient has DM with CKD that the code should be E11.22. In this instance, would I still want to utilize I12.9? My first inclination was to still use the I12.9 since there is a presumed relationship but I wanted to get some opinions from the rest of you to see what the correct reporting of codes should be. I couldn't find anything definitive in the guidelines.

Thank you!
-Denise
 
What if it just says DM with CKD? Like all throughout the progress notes, it says something like
1. DM with CKD
2. seizure d/o
3. anxiety
4. COPD

Will that be enough as a link or does it need to specifically state DM due to CKD or CKD secondary to DM? Thank you.
 
DM with CKD

Most of our DM pts have CKD or all complications.....I'm actually seeking further info on appropriate coding and guidelines that go to the specificity I need......but if the CKD resulted as a complication of DM, u would code the appropriate E code DM w/ nephropathy and 2nd dx being the N code to indicate stage of CKD......the clinic I work for specializes in endocrinology so I'm not certain if it would be coded different at nephrology clinic.....I've been told to code what you were treating.....in a nephrology setting ur not treating the DM, but the complication of......this might tempt u to use I12.9.....but it states unspecified......always supposed to code to the highest level of specificity.....which would take u back to DM w/ CKD......makes sense to me :)
 
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