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coding for patients with diabetes

  1. #1
    Default coding for patients with diabetes
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    When billing for patients with Type 2 Diabetes we need to add on the V58.67 as a secondary dx to specify that the patient is insulin dependent. If all patients with Type 1 Diabetes are insulin dependent, then do we still need to add on the V58.67 to specify insulin dependence?

  2. #2
    Default coding for type 1
    That's a good question. My thinking is that since taking insulin is inherent to Type I diabetes, you should not have to code for the insulin dependence, but since in Type II, not everyone is insulin dependent, that's what this code was designed for. I think in the case of Type I, V58.67 would be a redundant code.

  3. #3
    Default
    I thought it would be redundant also. But, I seem to be getting mixed answers to this question.

  4. #4
    Default coding for diabetes
    I'm not surprised you are getting mixed answers. I have found that whenever there is not a specific direction, it's left open for interpretation and not everyone is going to interpret it the same. Good luck!

  5. Default type 2
    My provider is telling me that her type 2 patients are converting to type 1 How do you code for this ??? I'm very confused and don't see anything that says this is correct. I was taught that type 2 who becomes insulin dependent you code the 250.00 with the V58.67 code to show the use of insulin..Help

  6. #6
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    Quote Originally Posted by nilewis View Post
    My provider is telling me that her type 2 patients are converting to type 1 How do you code for this ??? I'm very confused and don't see anything that says this is correct. I was taught that type 2 who becomes insulin dependent you code the 250.00 with the V58.67 code to show the use of insulin..Help
    Type 2 diabetes cannot progress or convert to type 1. I ran into this with a provider a few years ago and his rationale was he understood that when a type 2 patient became insulin dependent then they had converted or progressed to a type 1. This is absolutely not true, and I had to go to several medical textbooks and physiology definitions before I convince him that this is in fact incorrect. Is this the reason your provider is saying this? You cannot change a patient's diabetes type just to make certain services pay. However you can indicate type 2 with insulin dependence by appending the V58.67
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    Debra A. Mitchell, MSPH, CPC-H

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