Code for diet controlled condtion

dballard2004

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What ICD-9 code would you use for a lab draw of hyperlipedemia to show that the condition is diet controlled and not med controlled? Our coders have been using the code for dietery survallance and this does not seem correct to me. Is there an ICD-9 code for diet controlled conditions? Thanks.
 

dmaec

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I would use 272.4 for hyperlipidemia lab draw - IF that's what the order was for - "hyperlipidemia". Controlled or not, they still have hyperlipidemia - right?
I wouldn't use a surveillance code, not even secondary.
{that's my opinion on the posted matter}
 

dballard2004

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I am in total agreement. The problem is that my coders are telling me that Medicare requires a secondary code to explain if the condtion is med controlled or not. The problem is I have never been able to find anyone else who is having this same problem. Thanks.
 

dmaec

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hmm.. I've never heard of that before - but if you check your NCD list - 272.4 *IS* a covered dx for hyperlipidemia, no secondary dx is needed.
I guess I'd request a copy of whatever information they have that says you need a second dx to get the 272.4 covered and go from there. (on the phone to Medicare, etc).
Like I said, I've never heard of it, we've never had a problem with it being covered using just their hyperlipidemia code. And frankly, I wouldn't even know what secondary code to use, what do they use?
 

Lisa Bledsoe

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I am in total agreement. The problem is that my coders are telling me that Medicare requires a secondary code to explain if the condtion is med controlled or not. The problem is I have never been able to find anyone else who is having this same problem. Thanks.
I'm curious - do your coders feel the same way about diabetes? I've never heard of this either. I have seen LCD's that requires second diagnosis codes based on medial necessicty, but never to document that a condition is controlled by diet vs medication...
 

dballard2004

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I don't get it either. I think I will take your advice and ask for a denial to see exactly what they are talking about. Thanks.
 
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