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diabetes manifestations

  1. Default diabetes manifestations
    Medical Coding Books
    Can you pick up diabetes with neuropathy as a combination code if it is worded as such or does it need to be worded as diabetic neuropathy? Would it be the same with all of the manifestations? This has been called in question at my place of employment. It has been said that it has to be worded as due to, or worded as the diabetic neuropathy. This is for risk management coding.
    Last edited by suoyj; 08-26-2009 at 02:58 PM.

  2. #2
    Smile Diabetic Neuropathy ?
    I do risk adjustment, the answer to your question , for 2009 it has to state eithier due to or diabetic neuropathy. The documentation must link the 2 before you can combo code it. (due to 249.6/357.2 or diabetic neuropathy 250.6x/357.2).

  3. #3
    Location
    Columbia, MO
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    Quote Originally Posted by sdunn View Post
    I do risk adjustment, the answer to your question , for 2009 it has to state eithier due to or diabetic neuropathy. The documentation must link the 2 before you can combo code it. (due to 249.6/357.2 or diabetic neuropathy 250.6x/357.2).
    You are correct that the physician must link the two before you can code it but it has always been that way not just since 2009. I am uncertain what you mean by due to is 249.6(needs a 5th digit). Secondary diabetes is a different disease process from primary diabetes. If the physician states neuropathy due to diabetes this is still going to be 250.60 for the diabetes. Secondary diabetes is when the physician docuemnts that the diabetes is causal to something such as pancreatic cancer, or poisoning by steroids, or infectious process. So it is possible to have say neuropathy due to diabetes that is due to pancreatic cancer. THEN it would 249.6x but you would also have the pancreatic ca code as well as the 357.2 look at the coding guidelines from October 1 2008 for instruction regarding secondary diabetes.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default
    so in other words even if a physician links the two in his supporting documentation if in his assessment he says diabetes with neuropathy we should not assume a relationship?

  5. #5
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    That is correct, however if you find conflicting documentation I would query for clarification.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Location
    Milwaukee WI
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    Default "Due to" vs "with"
    Sometimes our physicians will argue that these two mean the same thing ... diabetes with neuropathy and neuropathy due to diabetes.

    I ask them, "So if you say diabetes with brain tumor, that means that the brain tumor was due to (caused by) the diabetes?"

    Well, naturally, they scoffed at that. My point exactly ... I cannot assume what they mean unless they are crystal clear. If there is truly a causal relationship, they must spell it out.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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