Clarification on the 2017 ICD-10 guidelines for HTN, CHF, and CKD with DM II

[almorris78]

Hello -

I am confused and need some clarification on the new guidelines for 2017 linking HTN with heart involvement (CAD, CHF, etc.) and CKD and the linking of DM with CKD.

I have an encounter for a patient that has documented and supported codes for HTN, CAD, CHF, DMII and CKD. As I read the guidelines, it states that we can now link Hypertensive heart and kidney diseases without specific provider documentation. It also states that we are able to make the same link for DM and CKD. I have no documentation stating that HTN or DM have caused any of these diseases, but I also don't have any provider documentation stating that they were not the cause either....

My questions is...can both of these combination codes exist simultaneously? Am I able to code I13.0 and E11.22 to link the hypertension and the DM to the kidney disease? THe HF type has been coded and supported as well as the CKD stage 3.

Thanks!

Amanda CPC-A, COC-A

 

[Thangamani]

Hello -

I am confused and need some clarification on the new guidelines for 2017 linking HTN with heart involvement (CAD, CHF, etc.) and CKD and the linking of DM with CKD.

I have an encounter for a patient that has documented and supported codes for HTN, CAD, CHF, DMII and CKD. As I read the guidelines, it states that we can now link Hypertensive heart and kidney diseases without specific provider documentation. It also states that we are able to make the same link for DM and CKD. I have no documentation stating that HTN or DM have caused any of these diseases, but I also don't have any provider documentation stating that they were not the cause either....

My questions is...can both of these combination codes exist simultaneously? Am I able to code I13.0 and E11.22 to link the hypertension and the DM to the kidney disease? THe HF type has been coded and supported as well as the CKD stage 3.

Thanks!

Amanda CPC-A, COC-A

Yes we can code I13.0, I50.9(Heart Failure type as Congestive HF) & E11.22. we can combine CKD with both HTN and DM unless there is no contradiction(such as cause of the disease..,) statement by the provider in the medical record.
1.Once the CKD is linked with DM in the record by the provider we cannot combine with HTN.
2.Once the CKD is linked with HTN in the record by the provider we cannot combine with DM.
3.If the provider itself make linkage with both DM & HTN with CKD we can code both.

 

[chaimz]

I agree with Thangamani.

 

[almorris78]

Thank you!

Yes we can code I13.0, I50.9(Heart Failure type as Congestive HF) & E11.22. we can combine CKD with both HTN and DM unless there is no contradiction(such as cause of the disease..,) statement by the provider in the medical record.
1.Once the CKD is linked with DM in the record by the provider we cannot combine with HTN.
2.Once the CKD is linked with HTN in the record by the provider we cannot combine with DM.
3.If the provider itself make linkage with both DM & HTN with CKD we can code both.

This is exactly what I was thinking, but I was not able to find anything that gave the specific information needed to determine if both these combo codes should exist together in the same encounter if the provider did not link any of them together. I appreciate your assistance and will pass the information along!