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diabetes

  1. #11
    Location
    Columbia, MO
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    12,940
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    Medical Coding Books
    The CDC removed from the definition of type I diabetes the term IDDM, it is not synonomous with type I. It was back in the day but no longer. This was changed in 2004 and it was either 1st quarter of 04 or 05 where coding clinics put out a clinic with just a ton of information on on diabetes and the physiology and why the definition has changed. But it does have to do with the issue of dependence based on the body's ability or inability to produce insulin to a degree. While one persons need for insulin may be due to type II diabetes their need is no less a dependence than a type I in some cases for without the insulin in both cases the patient will expire. So the issue is not for use to determine if one persons use is anothers dependence, however the guidelines are specific in that age nor insuline dependence shall determine for the coder the diabetes type.

    Debra A. Mitchell, MSPH, CPC-H

  2. Default
    I have a provider that is telling me that her type 2 diabetic patients are converting into type 1 and therefore the chart shows both types of diabetes in it for the patient. When I asked her about this she said that the insulin pumps will not get paid for with out the type 1 diagnosis for the patients. Please advise on the correct coding

  3. #13
    Location
    Columbia, MO
    Posts
    12,940
    Default
    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

    Debra A. Mitchell, MSPH, CPC-H

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