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Coding Diabetes with Hypertension

  1. Default Coding Diabetes with Hypertension
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    Looking for opinions on coding Diabetes with Hypertension.

    When coding in book, hypertension is not listed as a specified complication. Since hypertension is considered a circulatory complication I feel the correct code is E1159 rather than the more unspecified code of E1169 (other specified complication).

    How do you code this? Do you know of any Coding Clinics regarding this?

    Thank you!

  2. #2
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    I would code it as I10 for hypertension and E11.9 for diabetes.
    Devin Major, CPC
    HCA Healthcare
    Remote Cardiovascular Coder II
    Houston, Texas

  3. Default
    Thanks for that answer but this example is specifically for when:

    Diabetes is documented and supported with a complication of Hypertension.

  4. #4
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    As I understand the guidelines, if the provider has only documented "diabetes with hypertension", then you would not presume a causal relationship between the two because the two terms "diabetes" and "hypertension" are not linked in ICD-10 by the term "with". If the provider has specifically documented that the hypertension was caused by the diabetes, then you would code the hypertension as a circulatory complication. Only the terms listed in the index under "diabetes with" should be coded as a complication with specific documentation linking them. See the instructional note in Section I, part A - Conventions for the ICD-10-CM:

    The word “with” or “in” 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 two 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 terms in the classification or when a guideline requires that a linkage between two conditions be explicitly documented, provider documentation must link the conditions in order to code them as related.
    Thomas Field, CPC, CEMC

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