This is a sort of a personal rant but also professional.
A family member has Diabetes and numerous associated complications. Recently diagnosed with charcots arthropathy in her lower extremity joints and can barely walk or move with out pain. She has applied for disability and was denied due to the diagnosis. I asked what the diagnosis was.. she looked at her paperwork and from the ortho office they submitted
A52.16 Charcots arthropathy as the primary and
E11.40 Diabetic neuropathy unspecified as the secondary.
Now you may think that all looks really good.. However
A52 is the catergory for Late Syphilis !!!
and
A52.1 is the subcategory for symptomatic neurosyphilis
making A52.16 a condition caused by syphilis!!!
From an ortho coder!
The correct code is so easy to find under diabetes type 2 with arthropathy or charcot arthropathy and must be coded as E11.610.
I see this so many times where things are mis coded and they just don't care, they don't see how it affects the patient in the long run. Now she has to spend money to have test done that are not covered to prove that she does not have this condition and has never has syphilis.
It is not just about getting a claim paid.. it is doing your job correctly.
I am putting this out there to try to make this point to all who will read this and care. It does not matter if the provider but this code on or if the software assigned it.. A coder let this diagnosis leave her desk as an appropriate code and that is shameful!!