Wiki Coexisting with DM

[Velosarafter]

When coding for infectious diseases, should a patient with DM always have DM as a diagnosis code? Osteomyelitis, renal failure, abscesses, ulcers and a few others have a diagnosis code in the DM section. As of now, I only code what the provider has put down as a diagnosis. Charcot's Foot and neuropathy are the exception to when I have to investigate which one they have (idiopathic vs. diabetic). Also, once coded, does that mean that the provider is assuming care for that patient's DM, or it is just listed that it has been acknowledged as a factor that influences medical care?

Any help would be much appreciated.

Thanks!

 

[cathya35]

DM codes

In order to use the complication code, the doctor must link the diagnosis to the DM (with a couple exceptions, like osteomyelitis, gangrene, LOPS--also depends on ICD-9 vs ICD-10).

If DM is listed in the report and it affects patient care (treat, assess, monitor/medicate/manage, plan, evaluate, refer, etc). then I would code it.

Coding DM doesn't mean that the provider is assuming care for the DM but rather, like you stated, has been acknowledged as a factor that influences medical care.

 

[Velosarafter]

So if a patient has osteomyelitis and DM, I use the combination code?

 

[ndanh01]

Yes, you would use the combo code because DM and osteomyelitis is presumed to have a cause-and-effect relationship.

 

[cathya35]

DM and osteomyelitis

In ICD-9, there is a presumed cause-and-effect relationship between DM and osteomyelitis, but there is NOT a presumed cause-and-effect relationship between DM and osteomyelitis in ICD-10 so it has to be documented by the provider that they are linked before you can use the combination code in ICD-10. This is based on AHA Coding Clinic Q4 2013 (explanation here http://www.libmaneducation.com/coding-clinic-advice-diabetes-osteomyelitis-q4-2013/ )

 

[Velosarafter]

Ok. I appreciate the help.

Thank you!