Diabetes code

abill_423

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I need help with a diagnosis code. We saw a patient in the office today for follow up of a renal biopsy. His diagnosis was focal glomerulosclerosis. The pathologist also noted that "the presence of focal mild GBM thickening is indicative of early diabetic changes". This patient has never been diagnosed with diabetes. His glucose usually runs 75 - 95. He's never had a documented high or low glucose. And, he's not on any long-term medications. My physician has ordered a HgB A1C on this patient to follow up on this diagnosis. Would you just code the lab slip with V77.1 for diabetes screening? Do commercial payers cover this test?

Thanks for your input.
 

abill_423

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The biopsy was done for diagnostic purposes. The patient was consulted for evaluation of hematuria, proteinuria, and hypertension. He also has CKD stage 3. The physician's note says that the patient was healthy until he had a colonoscopy last September (for hemorrhoids) Blood pressure was noted to be elevated at that exam. This was felt to be secondary to the procedure. He saw his MD again in November, blood pressure still elevated. Labs done - UA showed blood and protein, blood work showed elevated creatinine. UA was negative for glucose and his glucose has never been elevated on any of the blood work he's had done. Past medical history has been fairly benign with the exception of an enlarged prostate. The only other thing that I can find in his history is that he has had frequency, nocturia and urgency.

Thanks.
 
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