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Wiki help with DM coding

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perkins05

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We have an insurance auditor that is telling us that we must code both DM (250.00) and DM with renal manfestiations (250.40 & 585.3) on the same claim.

Is was my understanding IF the patient has DM with manfestation that DM was covered by the 250.40 code. I think adding 250.00 to these encounter is over kill.

Any suggestions or opinions are greatly appreciated!

Thanks:confused:
 
the insurance auditor is totally incorrect! your patient cannot have "no complication", and a complication at the same time. 250.00 states with no complication. The coding guidelines also state this.
 
Debra is totally correct, I always instruct my providers that once a complication exists then the 250.00 has to go away becuase the complication exists and therefore the uncomplicated no longer exists.
 
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