Wiki DM w/ HTN

[cmedina969800]

Hey fellow coders!

We recently had a visit from a document trainer/coder from Optum, and she mentioned that if a patient has DM w/ HTN should be coded as E11.59 and I10. It sounds like the reason for this was to fully capture our HCC/Risk coding.

Is everyone doing this?

What are your thoughts?

 

[Cynthia Hughes]

ICD-10 does not indicate a causal relationship in diabetes and hypertension

Hey fellow coders!

We recently had a visit from a document trainer/coder from Optum, and she mentioned that if a patient has DM w/ HTN should be coded as E11.59 and I10. It sounds like the reason for this was to fully capture our HCC/Risk coding.

Is everyone doing this?

What are your thoughts?

I have to disagree. The guidelines only allow for assuming a causal relationship for conditions that are linked in the alphabetic index with terms "with" or "in" (see guideline 15 in Section IA). There are no listings in the index to support assuming diabetes as the cause of hypertension. If your physician does not document a causal relationship (e.g., hypertension due to diabetes), it is not appropriate to code as you were advised.

I hope this is helpful.
Cindy

 

[nitinnadar]

Hi Cynthia Hughes

You are right at ur point of view however as per the original question DM is already linked with HTN . IF provider himself is linking these two condition( DM W/ HTN) the correct way of coding hcc codes will be E11.59 and I10.


Rational:
HTN (I10) is a circulatory complication and if you see the description of E11.59 - Type 2 diabetes mellitus with other circulatory complications.

So E11.59, I10 is the correct practice of coding these two codes when linked by provider.