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Dm + hf

  1. Default Dm + hf
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    An audit showed that DM + HF is assumed as complication of E11.59. Is there info regarding this?

  2. #2
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    Heart Disease is common in people with diabetes.Data from the National HeartAssociation shows 65% of people with diabeteswill die from some sort of heart disease, failure, or stroke. In general, therisk of heart disease,death and strokeare twice as high in people with diabetes.

    The National Diabetes Association also considers heart disease a specific complication of diabetes.
    Chelle Johnson, CPC CPMA CDEO CEMC CPCO CPPM AAPC Fellow
    Billing/Coding/Credentialing/Auditing Coordinator

    20+ years experience in Medical Billing and Auditing

  3. Default
    DM + HF isn't really linked well, if the documentation literally used a + sign, I wouldn't consider that proper linkage.

    A few things to consider

    Clinicians should not document with arrows or symbols and if they do, we should never code from it.
    While heart failure and other heart diseases are well known complications of diabetes, they must be linked by the clinician.
    The Coding Guidelines and index do not list heart failure under the "with" category, which means we can't assume the linkage.

  4. #4
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    DM and HF are not an allowed assumed linkage. The provider will need to document that the HF is due to the diabetes. To be an assumed relationship the HF would need to be listed under the word with in the alpha index under the Key word diabetes.

    Debra A. Mitchell, MSPH, CPC-H

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