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Wiki Diabetes & CKD help!!!

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Edithcha

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Miami, FL
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Hello,

We have a case where the patient case is very complex. The patient has Diabetes, with hyperglycemia, with polyneuropathy, CKD stage 3, and using insulin. I found the following codes, but I'm not sure of the combination or correct order. Should I include both codes of diabetes with polyneuropathy and CKD, or should I code them separately? Please help!!!!

E11.42 diabetes with polyneuropathy
E11.22 diabetes with CKD
N18.3 CKD stage 3
E11.65 diabetes with hyperglycemia
Z79.4 insulin use

:confused:
 
Per the Official Guidelines for Chapter 4: "As many codes within a particular category as are necessary to describe all of the complications of the disease may be used. They should be sequenced based on the reason for a particular encounter. Assign as many codes from category E08-E13 as nmeeded to identify all of the associated conditions the patient has."

I can't advise you on the sequencing in your example because I'm not sure which condition was paramount. Maybe E11.65 should go first - but I think all your codes are correct and I would code the same way.
 
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