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Wiki Coding "due to"

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mcdream

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Hi all! In need of guidance when provider documents "due to" but the classification does not presume a causal relationship between the two conditions (conditions not linked by "due to" in the alpha index).
Scenario
Provider documented: "Hypothyroidism due to Hashimoto's thyroiditis"
DGs state: "For conditions not specifically linked by relational terms (with/due to) in the classification, provider documentation must link the conditions in order to code them as related.
Question: would you code "Hypothyroidism due to Hashimoto's thyroiditis" as:
E06.3 Hashimoto's thyroiditis (primary, since it's the underlying condition) & E03.9 Hypothyroidism, unspecified?
Or
E06.3 Hashimoto's thyroiditis (primary) & E03.8 other specified hypothyroidism

Thanks for your help on this!
 
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McCrea - Hashimoto's is a specific type of hypothyroidism. It is autoimmune in nature. I've never worked in Endocrinolgy but I my guess would be that in order to make a diagnosis of Hashimoto's Hypothyroidism, in addition to abnormal thyroid levels, there are certain inflammatory markers (sed rate, CRP) that must be elevated. I think this affects the way it is managed. Rather than just replacing the thyroid hormone, the inflammation must be monitored and managed. Unfortunately personal experience has taught me more than I wanted to know about hypothyroidism. My niece and I were diagnosed within months of one another. Mine was just old lady hypothyroidism (59) and her's is Hashimoto's (she's 27). Mine, easily managed with a low dose of Synthroid, her's requiring constant adjustments. Hope this helps.
 
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mcdream said:
Talton- thank you for your reply. I'm wondering why you would not code both hypothyroidism & hashimotos since they are two separate diagnoses (patient has both conditions)? Thank you for your help!
Click to expand...

I agree that it should be E06.3 only. In the book, Hypothyroidism -> Autoimmune is the same code (E06.3) as Hashimoto's Thyroiditis.
 
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