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Thread: sequencing order in office coding?

  1. #1

    Default sequencing order in office coding?

    AAPC: Back to School
    Does anyone know of a source that indicates why it is stated that the order for sequencing 250.40, 403.90 and 585.3 requires Diabetes to be sequenced first?

  2. #2
    Join Date
    Apr 2007
    Kingsport, TN


    In the ICD-9-CM, under coding guidelines, Section I in Chapter 3 there are instructions for sequencing diabetes codes and associated conditions. I hope this helps.

  3. #3

    Default sequencing

    That section discusses diabetes and its manifestations. It does not state why diabetes would be sequenced first when you have a co-equal co-morbidity also with renal involvement, such as hypertension with stage III kidney disease that is documented along with diabetes with renal manifestation. I am trying to find an authoritative source, other than a coding clinic which just states this is the case but does not tell us why.

  4. #4
    Join Date
    Apr 2007
    Kingsport, TN


    Sorry I couldn't be of more help. I'm sure someone out there will have the answer you are looking for.

  5. #5
    Join Date
    Apr 2007
    Louisville, KY


    Why is it necessary to justify the purpose of a coding guideline? ICD-9 is rather authoritative in my eyes. Sequencing is based on capturing data in a uniform and recognizable fashion. Even then, you still have providers and claim submitters who do not abide by those standards. Stardardization is the key to many of the ICD manual's requirements, so I'd suspect it to be so in this case as well.

    Good luck!
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

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