Insulin resistance

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I need an icd-9 code for "insulin resistance". The doctor did not mention dysmetabolic syndrome x so I dont think that 277.7 would be appropriate. Patient has a history of gestational diabetes in past. No lab work on file yet so I cannot code abnormal lab work findings. I am assuming he is basing his dx on the HPI symptoms of brain fog and mood swings. Help.:confused: I think I saw an article on this recently, but I cant find it.
 

mitchellde

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I am wondering how he comes up with insulin resistance based on brain for and mood swings! There is either something he is not documenting or he is giving this as a rule out, I think you have to code the sysmptoms or ask for more documentation. I read an article once that described type 2 diabetes as an insulin resistant disease process, among other things. Maybe query the physician to see if this is the direction he is going, then maybe you can code for screening if he ordered any tests. Thats all I cam come up with.
 
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Insulin Resistance

According to Wikipedia, the symptoms of IR include
Symptoms of IR


  1. Fatigue.
  2. Brain fogginess and inability to focus. Sometimes the fatigue is physical, but often it is mental.
  3. High blood sugar.
  4. Intestinal bloating. Most intestinal gas is produced from carbohydrates in the diet. Insulin resistance sufferers who eat carbohydrates sometimes suffer from gas.
  5. Sleepiness. Many people with insulin resistance get sleepy immediately after eating a meal containing more than 20% or 30% carbohydrates.
  6. Weight gain, fat storage, difficulty losing weight. For most people, too much weight is too much fat. The fat in IR is generally stored in and around abdominal organs in both males and females. It is currently suspected that hormonal effects from such fat are a precipitating cause of insulin resistance.
  7. Increased blood triglyceride levels.
  8. Increased blood pressure. Many people with hypertension are either diabetic or pre-diabetic and have elevated insulin levels due to insulin resistance. One of insulin's effects is on arterial walls throughout the body.
  9. Depression. Because of the deranged metabolism resulting from insulin resistance, psychological effects are not uncommon. Depression is said to be the prevalent psychological symptom.
 
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