Wiki Longterm drug use

[kumeena]

Good morning everyone

Patient is Insulin Dependent DM (IDDM) . Is it consider Type 1 DM.
Should I use V58.67 along with DM code. What is the time frame/guidelines for the word "Long term"

Thank U

 

[mitchellde]

Diabetes type cannot be determine by age or insulin dependence. If the physician does not specify type then per the guidelines you default it to type 2. If the patient has been prescribed insulin then it is considered to be long-term(current) usage for the V58.67. We do not add this code to the type 1 designations only to those that are type 2 and insulin dependent.
You also need to know the difference between primary diabetes 250.xx and secondary diabetes 249.xx to be sure you are coding the patient's condition accurately.

 

[KellyLR]

Can't go by IDDM

Diabetes type cannot be determine by age or insulin dependence. If the physician does not specify type then per the guidelines you default it to type 2. If the patient has been prescribed insulin then it is considered to be long-term(current) usage for the V58.67. We do not add this code to the type 1 designations only to those that are type 2 and insulin dependent.
You also need to know the difference between primary diabetes 250.xx and secondary diabetes 249.xx to be sure you are coding the patient's condition accurately.

She's right. There has been much discussion about how to document and what is the guideline for long-term use. That would depend if the doctor generously documents long-term usage in the medical record. Also and most importantly, know the medications and how they are used. Some are for treating long-term conditions and some others are not. Some medications ride the fence. Can be short-term or long-term use.
You may revert to Type 2 Diabetes as the default as stated in the ICD-9 guidelines. The provider really needs to state which type of Diabetes has been diagnosed. This is tricky when inferred from documentation. Especially for HCC coders.