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diabetic patient with decubitus ulcers

  1. #1
    Default diabetic patient with decubitus ulcers
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    Hello everyone,
    I was looking through the ICD-9 guidelines for an answer to this question and couldn't find it. A patient is seen in consultation for a stage 4 decubitus ulcer. The doctor documents that the patient has diabetes, but does not necessarily say that the ulcers are a complication from the diabetes. Do I still use the 250.80 code for the diabetic manifestation, or do I just code the site and stage of the ulcer???

    thanks to you all.....
    Malama pono,

    Sundae Yomes
    CPC, CPMA, CEMC, CGIC, CGSC, CCS-P

  2. Default Diabetic codes
    Quote Originally Posted by sundaey View Post
    Hello everyone,
    I was looking through the ICD-9 guidelines for an answer to this question and couldn't find it. A patient is seen in consultation for a stage 4 decubitus ulcer. The doctor documents that the patient has diabetes, but does not necessarily say that the ulcers are a complication from the diabetes. Do I still use the 250.80 code for the diabetic manifestation, or do I just code the site and stage of the ulcer???

    thanks to you all.....
    What I have seen most for diabetic complications are the decubitus ulcers on the feet. Is the patient bedridden? I would just code decubitis ulcer 707.03 and code the diabetes. I do code for the heel decubitis as 707.14 and the 205.60 if the patient has peripheral neuropathy. Hope this helps.

  3. #3
    Location
    Milwaukee WI
    Posts
    4,466
    Default Doctor MUST make the connection
    In order to use the 250.xx series of codes the provider MUST make the connection for you.

    If he didn't, then code the ulcer and the diabetes as separate diagnoses.

    F Tessa Bartels, CPC, CEMC

  4. #4
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by sundaey View Post
    Hello everyone,
    I was looking through the ICD-9 guidelines for an answer to this question and couldn't find it. A patient is seen in consultation for a stage 4 decubitus ulcer. The doctor documents that the patient has diabetes, but does not necessarily say that the ulcers are a complication from the diabetes. Do I still use the 250.80 code for the diabetic manifestation, or do I just code the site and stage of the ulcer???

    thanks to you all.....
    The doctor does not make the connection, and the guidelines do not require the causal condition (as is the case with 707.1_), so you do not need to code the diabetes, but you certainly could, and perhaps should since it is documented.

    And you definitely should use the additional code for the stage of the ulcer, so....
    707.00, 707.24,250.00 is how I would code this scenario.
    Last edited by dpeoples; 09-25-2009 at 11:49 AM. Reason: agreement with debra on diabetes code :)
    Danny L. Peoples
    CIRCC,CPC

  5. #5
    Location
    Columbia, MO
    Posts
    12,557
    Default
    I would not code the diabetes AS 250.80 since this is not documented as a complication of the diabetes. The diabetes code then would be 250.00, listing the ulcer and the stage first.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Default
    I agree with Debra. Only the kidney problems for Diabetic patients we can link together. Otherwise no documentation from the Doctor (Ex: diabetic neuropathy/ due to diabetes )we can not code it

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