Wiki Uncertain diagnosis with diabetes

[LuckyLily]

In Coding Clinic 2021, 1Q, pg 11 touches on conditions linked by the 'with' guideline but uncertain language is used. It states 'When the linkage between two diagnoses is documented in terms indicating uncertainty, the Uncertain Diagnosis guideline applies, and a combination code indicating a presumed linkage should not be assigned.'

How does this apply with the 2016, 2Q, pg 36 guidance about Diabetes. 'This link can be assumed since the chronic kidney disease is listed under the subterm “with.” 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 and due to some other underlying cause besides diabetes.'

Is "Diabetes likely due to CKD" still presumed or follow the Uncertain Diagnosis guideline in the outpatient setting?

Correction: It should state "CKD likely due to Diabetes"

 

[sls314]

If there is a confirmed diagnosis of both diabetes and CKD, I would assign E11.22. The provider doesn’t need to explicitly link the two conditions to use this code, so IMO the word "likely" doesn't affect the use of the With guideline.

Since the provider’s statement of “likely due to CKD” doesn’t clearly indicate the conditions are unrelated, I would proceed with coding E11.22.