I am auditing a specialty practice and they disagree with me regarding the documentation and coding of ICD-9 pertaining to Diabetes and manifestations.
Does anyone know of any place I can get "black and white" proof of what is required when using a diabetes with manifestation code?
Scenario:
Physician documents type II diabetes, uncontrolled. No where in that visit's documentation does it mention any manifestations. But the coding they provide is diabetes type II uncontrolled with renal manifestation. Nor do they provide information on what the actual manifestation is.
Their argument is that in the patient's chart, it has previously been noted that they have diabetes with chronic kidney failure.
My statement is that if they are going to bill for diabetes with manifestations, this has to be clearly noted as such...ie. diabetes type II, uncontrolled with associated chronic kidney failure, stage 3.
Can any give me some direction here?
Thanks,
Tina Coleman CPC, CPMA
Does anyone know of any place I can get "black and white" proof of what is required when using a diabetes with manifestation code?
Scenario:
Physician documents type II diabetes, uncontrolled. No where in that visit's documentation does it mention any manifestations. But the coding they provide is diabetes type II uncontrolled with renal manifestation. Nor do they provide information on what the actual manifestation is.
Their argument is that in the patient's chart, it has previously been noted that they have diabetes with chronic kidney failure.
My statement is that if they are going to bill for diabetes with manifestations, this has to be clearly noted as such...ie. diabetes type II, uncontrolled with associated chronic kidney failure, stage 3.
Can any give me some direction here?
Thanks,
Tina Coleman CPC, CPMA