"with"

dukemell

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2017 ICD-10 guidelines #15 "With"
The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the alphabetic index, or an instructional note in the tabular list. The classification presumes a causal relationship between the 2 conditions linked by these terms in the alphabetic index or tabular list. 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. For conditions not specifically linked by these relational items in the classification, provider documentation must link the conditions in order to code them as related. The word "with" in the alphabetic index is sequenced immediately following the main term, not in alphabetic order.

This guideline is off the CMS website. The guidelines in front of the 2017 code book are from 2016. The book was printed before the guidelines were complete.
Please clarify the above guideline. Does this mean that if a patient has Diabetes & CKD I can use the combination code of E11.22 & Ni8.-, without the Dr documenting DM CKD? I believe I can. Thank you.
 

mitchellde

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the guidelines are in the 2017 set as well and were also present in the ICD-9 guidelines. Yes that means if the Alph index indicates "with" under the main term such as diabetes, then you code as combined even without the provider stating it. so yes you would code CKD and diabetes as diabetic CKD.
 

dukemell

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the guidelines are in the 2017 set as well and were also present in the ICD-9 guidelines. Yes that means if the Alph index indicates "with" under the main term such as diabetes, then you code as combined even without the provider stating it. so yes you would code CKD and diabetes as diabetic CKD.

Thank you. If you read other posts concerning "with" you get conflicting responses.
 

mitchellde

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The guideline did not change, they only added clarity due to confusion, what changed with Oct 1 2015 was the alpha listing. That is what has made the difference between being able to assume the causal relationship and needing to have it stated by the provider. That is why you must pay attention to not just new codes but changes to how things are listed and worded.
 
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