Wiki Diabetes Ketoacidosis & Persistent Asthma Codes (?)

[md4mds]

I have read (from one lecture note) that Diabetic Ketoacidosis is always coded as Type 1 if not stated as Type 2 and it is always coded as uncontrolled. Is this right? Also, if the dx given is "Persistent Asthma", is 493.90 (unspecified) the correct code to use? Thank you!

 

[lavanyamohan]

Hello,
Type I diabetes - Pancreas does not secrete enough insulin; begins at young age;
Type II diabetes - insulin resistance offered by cells and hence reuptake of insulin by cells is not sufficient; Due to ageing and or irregular dietary patterns;

Ketoacidosis is often a condition that occurs due to insulin insufficiency;
Can code Type I diabetes if not specified otherwise;
But uncontrolled or controlled may not be considered without being mentioned;

Regarding persistent asthma, 493.90 can be considered, too.


Regards,
L Mohan

 

[mitchellde]

I disagree, you may not assume type I diabetes even if it is stated ketoacidosis. The coding guidelines state that unless specified by the physician as type I we are to code as type II. While type I typically occurs in the young it is not restricted to the young. I have had middle age folks diagnosed as type I for the first time as middle aged. Aslo I have had young children diagnosed as type II. This is not a disease process that is age related, it is however related to the pancreatic beta cells. Also you can have ketoacidosis with secondary diabetes which is neither type I or type II but is controlled or uncontrolled. Therefore unless specified as type I we are to code as type II and you should read carefull to make sure this is primary and not secondary diabetes.

 

[Lisa Bledsoe]

I agree with Debra. Read the ICD-9-CM coding guidelines - they clearly state "if the type of diabetes mellitis is not documented in the medical record the default type is II".