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  1. Question Urgent
    Medical Coding Books

    The question is about DM/W manifestations
    250.70 Diabetes TypeII W Periph vasc dis
    586 Renal failure
    401.9 Hypertension nos controlled
    250.40 diabetes typeII W renal manifestations

    Exactly how would you code this and why?

  2. #2
    Columbia, MO
    what was the reason for the encounter and how was all this documented.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    You do have to reveiw the documents to see if the renal was due to the DM or the HTN or maybe not, if it does indicate this in the document you must use the DM code along with one of the options listed below in the ICD-9 book, or if it indicates renal disease with the HTN. This is why you must look through the documentation to help clarify how it was indicated within the chart so you know which codes you are using. Just thought I would throw my two cents in to help you to understand why if was referred to you to look back through the document and what you want to be looking for. Hope this helps.

  4. Post hcc
    Good Morning Lisa,

    We are auditing the records from a medical group and they either under code or up code. The pt came in for a routine check up. Nothing special was done on that visit. The confusion came in from if we can link the 250.40 with the 586(renal failure) because we are linking the HTN 403.90 with this.

    Thank you in advance for your assistance

  5. #5
    Columbia, MO
    You only link the renal failure to the HTN if it is chronic kidney disease (any code form the 585 category) or when documented by the physician. so a 586 cannot be auto linked with the HTN, and you cannot auto link the 586 with the diabetes this must be documented by the physicna as being due to or causal to the diabetes. This is why I indicated to see what the documentation stated.
    This is all from the coding guidelines.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Albany, New York
    Thanks Deb....was working on a response to this.
    You covered it very well.
    Karen Maloney, CPC
    Data Quality Specialist

  7. Post Thanks
    I wanted to say thank you to you ladies. I will forward this info to my co-workers.

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