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Diabetes Ketoacidosis & Persistent Asthma Codes (?)

  1. #1
    Default Diabetes Ketoacidosis & Persistent Asthma Codes (?)
    Clearnace Sale
    I have read (from one lecture note) that Diabetic Ketoacidosis is always coded as Type 1 if not stated as Type 2 and it is always coded as uncontrolled. Is this right? Also, if the dx given is "Persistent Asthma", is 493.90 (unspecified) the correct code to use? Thank you!

  2. Default
    Type I diabetes - Pancreas does not secrete enough insulin; begins at young age;
    Type II diabetes - insulin resistance offered by cells and hence reuptake of insulin by cells is not sufficient; Due to ageing and or irregular dietary patterns;

    Ketoacidosis is often a condition that occurs due to insulin insufficiency;
    Can code Type I diabetes if not specified otherwise;
    But uncontrolled or controlled may not be considered without being mentioned;

    Regarding persistent asthma, 493.90 can be considered, too.

    L Mohan

  3. #3
    Columbia, MO
    I disagree, you may not assume type I diabetes even if it is stated ketoacidosis. The coding guidelines state that unless specified by the physician as type I we are to code as type II. While type I typically occurs in the young it is not restricted to the young. I have had middle age folks diagnosed as type I for the first time as middle aged. Aslo I have had young children diagnosed as type II. This is not a disease process that is age related, it is however related to the pancreatic beta cells. Also you can have ketoacidosis with secondary diabetes which is neither type I or type II but is controlled or uncontrolled. Therefore unless specified as type I we are to code as type II and you should read carefull to make sure this is primary and not secondary diabetes.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Greeley, Colorado
    I agree with Debra. Read the ICD-9-CM coding guidelines - they clearly state "if the type of diabetes mellitis is not documented in the medical record the default type is II".
    Lisa Bledsoe, CPC, CPMA

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