Answer ICD-10

bharathiT

Guru
Messages
104
Location
Salem, Tamil Nadu
Best answers
0
The documentation states that Hypertension (I10) & DM (E11.9).
In this case , want to code I15.2 (Hypertension secondary to endocrine disorders) AND E11.9(Type 2 diabetes mellitus) or either one combo?

Kindly clarify on this
 

thomas7331

True Blue
Messages
2,288
Best answers
5
As per ICD -10 Guidelines, the term With ,or due to ,associated with are interpreted to mean same. index book sates hypertension due to endocrine disorders (I15.2).

Kindly clarify this, have lot of confusiono_O
Yes, you're correct, the terms means the same thing, but they are not interchangeable. In this case the doctor did not document 'due to'.

The ICD-10 guidelines only for a coder to presume the causal relationship (in other words, assume 'due to') when the term 'with' or 'in' appears in a code title, the Alphabetic Index...or an instructional note in the Tabular List. So if you are looking up 'hypertension' in the alphabetic index, the only conditions listed under 'with' are 'heart failure', 'heart involvement' and 'kidney involvement'. So these three are the only conditions which you can conclude are caused by the hypertension in the absence of physician documentation of the causation - if the two conditions both exist at the encounter, you code the entry under 'with' even if there is no relationship documented. However, to code the conditions listed under 'due to', the documentation must support that this condition caused the hypertension.

Another way to look at it is that 'with' and 'in', in ICD-10, mean simple that the two conditions both are present in the documentation. 'Due to' does not allow this - this term must be documented.
 
Last edited:

thomas7331

True Blue
Messages
2,288
Best answers
5
There is no presumed causality between hypertension and DM. If the provider has not documented that this is secondary hypertension, then this should be coded as I10, E11.9.
 

bharathiT

Guru
Messages
104
Location
Salem, Tamil Nadu
Best answers
0
Please explain the ICD -10 Guideline?


The word “with” should be interpreted to mean “associated with” or “due to” when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The classification presumes a causal relationship between the two conditions linked by these terms in the Alphabetic Index or Tabular List. These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated. For conditions not specifically linked by these relational terms in the classification, provider documentation must link the conditions in order to code them as related.
 

michellepilcher

Networker
Messages
86
Location
Anchorage , AK
Best answers
0
Please explain the ICD -10 Guideline?


The word “with” should be interpreted to mean “associated with” or “due to” when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The classification presumes a causal relationship between the two conditions linked by these terms in the Alphabetic Index or Tabular List. These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated. For conditions not specifically linked by these relational terms in the classification, provider documentation must link the conditions in order to code them as related.

It means just that. If a patient has chronic kidney disease and hypertension, it is presumed they are related and they are linked. If the patient has cardiovascular disease and hypertension it is presumed they are linked. In those cases there is a code that links them rather than using two separate codes. There is no code that links diabetes and hypertension. I15.2 is secondary hypertension. Those types of illnesses are aldosteronism, pheochromocytoma, Cushing's syndrome, hyperparathyroidism and hypo- and hyperthyroidism.
 

bharathiT

Guru
Messages
104
Location
Salem, Tamil Nadu
Best answers
0
As per ICD -10 Guidelines, the term With ,or due to ,associated with are interpreted to mean same. index book sates hypertension due to endocrine disorders (I15.2).

Kindly clarify this, have lot of confusiono_O
 

Attachments

Munzueta

Guru
Messages
136
Location
El Paso
Best answers
0
Hello,

completely agree with above.

So if I may add, in other words, if you want to use I15.2, your index will have to show something like this.

Hypertension
with
diabetes mellitus

that will be the only way you could code it as such, but well the book doesn't have it, just be careful with the "with" and "in"

you will not be linking every single condition with diabetes, only the ones listed on the alphabetic index for example,

Diabetes
with
amyotrophy
arthropathy
chronic kidney disease

so if a patient has a diagnosis of Chronic kidney disease and diabetes, and there is no linkage of both conditions, in this case you would be able to code with the E11.22 combining CKD and diabetes and then also adding the N18.9. We are doing this because your index provides a specific "with" entry for chronic kidney disease under diabetes melliltus.

Hope this paints a better picture!
Marco
 
Messages
2
Best answers
0
Hello,

I have a similar situation to this forum. Medical documentation states Chronic Kidney Disease stage III, Diabetes Mellitus type 2 without complications, and long standing hypertension. Do I assume a relationship with Diabetes/CKD and Hypertension/CKD when coding? So my codes would be E11.22, I12.9, and N18.3? or would I code each dx separately so E11.9, I10, N18.3? The documentation does state "Probably secondary to diabetic and or/ hypertensive nephropathy" Also, does this constitute coding for E11.69?

Thanks!
 

Munzueta

Guru
Messages
136
Location
El Paso
Best answers
0
Hello,

I have a similar situation to this forum. Medical documentation states Chronic Kidney Disease stage III, Diabetes Mellitus type 2 without complications, and long standing hypertension. Do I assume a relationship with Diabetes/CKD and Hypertension/CKD when coding? So my codes would be E11.22, I12.9, and N18.3? or would I code each dx separately so E11.9, I10, N18.3? The documentation does state "Probably secondary to diabetic and or/ hypertensive nephropathy" Also, does this constitute coding for E11.69?

Thanks!
Yes, your guidelines allow you to assume a causal relationship between hypertension and CKD, and also between DM and CKD. So yes, use the appropriate combination codes, being E11.22, I12.9 and N18.3.

I do not see why you would apply E11.69, is there a specific reason you were wondering about that code?
 
Messages
2
Best answers
0
Yes, your guidelines allow you to assume a causal relationship between hypertension and CKD, and also between DM and CKD. So yes, use the appropriate combination codes, being E11.22, I12.9 and N18.3.

I do not see why you would apply E11.69, is there a specific reason you were wondering about that code?

My thought process was the document states DM Type 2 without Complications but thinking CKD is a complication. I guess I just wasn't sure if that meant you needed to code DM type 2 with complications along with E11.22.
 

Munzueta

Guru
Messages
136
Location
El Paso
Best answers
0
If the patient only had a diagnosis of DM2 without complications, then you would be looking at E11.9 of course.

Now, if the patient has a diagnosis of DM2 and CKD, then at that point the code E11.22 covers the diabetes WITH complication being CKD, then the code asks for an additional code to specify the stage of the CKD being the N18.3.

Hope this helps.
 

mcdream

Networker
Messages
43
Best answers
0
I too have a similar question regarding the use of E11.69.
Documentation states: T2DM complicated by CAD, CHF. Does this constitute coding E11.69 in addition to I25.10 & I50.9?
TIA
 
Top