drksingh
Contributor
Hello AAPC Coding members,
I am having a hard time finding a reason to code for E11.8. This emerged from a conversation with a fellow Provider who is a coder (in his world). His explanation was whenever there is a complicated DM type 2 patient who is on the Metformin with or w/o insulin, he would put E11.8 as DM2 with complications, followed by Z79.84 for Long term (current) use of oral hypoglycemic drugs or the Z79.4 for use of insulin. I was amazed. His explanation was that DM2 patients do have complications and the code allows him to get by and yet achieve the HCC status if there is no specific complication to point to but he believes the patient is complicated otherwise.
In my search, I cannot find a good reason to code for E11.8, because if the provider noticed a complication of DM, you will notate in the medical record e.g. neuropathy, hyperglycemia, poor-control, etc.
So my question is - In what scenario will really E11.8 be worth coding for?
Looking for some amazing answers or scenarios. Thanks in advance.
I am having a hard time finding a reason to code for E11.8. This emerged from a conversation with a fellow Provider who is a coder (in his world). His explanation was whenever there is a complicated DM type 2 patient who is on the Metformin with or w/o insulin, he would put E11.8 as DM2 with complications, followed by Z79.84 for Long term (current) use of oral hypoglycemic drugs or the Z79.4 for use of insulin. I was amazed. His explanation was that DM2 patients do have complications and the code allows him to get by and yet achieve the HCC status if there is no specific complication to point to but he believes the patient is complicated otherwise.
In my search, I cannot find a good reason to code for E11.8, because if the provider noticed a complication of DM, you will notate in the medical record e.g. neuropathy, hyperglycemia, poor-control, etc.
So my question is - In what scenario will really E11.8 be worth coding for?
Looking for some amazing answers or scenarios. Thanks in advance.