Wiki Need clarification on E11.22 code DM with diabetic Chronic Kidney Disease- Add code

[mchaidez]

The Discharge diagnoses were documented asfollow:

Acute CHF exacerbation- Resolved, EF=55%
Right pleural effusion with atelectasis
CKD
Diabetes Mellitus

I coded the following:

I50.9
J91.8
J98.11
E11.22
N18.9

Per the book to code E11.22 - Use additional code to identify stage of Chronic Kidney Disease (N18.1-N18.6)

In this case the physician did not specify the stage, Can I still code E11.22 and include N18.9?

Thanks,
M

 

[mitchellde]

Yes add the N18.9, but The CHF is documented as resolved and per guidelines we do not code resolved conditions so I would drop the I50.9

 

[mchaidez]

THANK YOU

 

[rmwinder]

However, you would code the CHF if this was an inpatient record. And even in an Outpatient setting, CHF is seldom just resolved - although if definitely can be resolved. If you have a way to query your doctor, ask if the CHF exacerbation is resolved, but do they still have CHF? If so, and if they're still on Furosemide, or Lasix, I would still pick it up.
Also, if you are coding for risk adjustment only, then no...you do not code N18.9 with E11.22, like you thought. You would only code N18.3 - N18.6 for 2018 dates of service as those are the only CKD's that risk adjust (for 2018). That may be different if you're coding 2019 encounters. If you are doing full capture - then yes, pick up all the codes. I suppose it all depends on what you're doing. Inpatient, outpatient, risk adjustment or full capture. : )

 

[Vdudala]

presumes a cause and- effect relationship between both diabetes and CKD and hypertension and CKD. so coding for E11.22 when CKD is documented in the chart

as its documented as AE CHF you would code it but, query MD for type of CHF.
Code J91.8 Pleural effusion in other conditions classified elsewhere, is assigned as a secondary code ... ONLY if the condition is specifically evaluated or treated.

Hope this helps