sec DM vs DM

ms2fine

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I have a physician who is documenting sec DM on a PN as well as DM. According to coding guidelines sec DM has to have sequencing of relationship to other diag. So my question is if there is no reason for the physician to document sec DM do you not code it all or assume he /she is trying to document just regular DM
 

mitchellde

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I think there is confusion over what exactly secondary DM is. There must be a cause and effect relationship documented for secondary diabetes, such as diabetes due to steriods, or due to pancreatitis, or pancreatectomy. The diabetes has to be due to something else for it to be secondary diabetes, you follow the guidelines on sequencing, depending on why the patient is there will determine whether the 249.xx is sequenced first or the underlying condition is sequenced first.
 
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