Wiki Diabetes & General ICD-9 coding rules

[SHIBA425]

The final impression states:
1) Diabetes type II, uncontrolled
2) Nephropathy: Microalbuminuria, hypertension
3) Macrovascular: Hyperlipidemia
4) Neuropahy: Peripheral, hypoglycemia unawareness

Now the codes the Provider coded on the charge ticket are:
1) 250.02
2) 250.42
3) 401.9
4) 272.4
5) 250.62

It has always been my understanding according to the ICD-9-CM coding guidelines that unless the Provider specifically states "diabetic nephropathy" or "Diabetic periperheral neuropathy" that you can not code it as a diabetic related complication from categories 250.1X -250.9X.

I would code as follows according to the documentation of the final impression:
1) 250.02
2) 583.9
3) 791.0
4) 401.9
5) 272.4
6) 356.9
7) 251.2

Does anyone agree/disagree? Am I wrong in my interpretation of the guidelines?

I would appreciate any and all feedback.
Thank you
Jean

 

[mitchellde]

The chart note would need to specify that these are complications of the diabetes before you could code it, and then you would list the specific complication as additional codes to the diabetes with complication. I would not code this without the chart note.