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steroid induced diabetes

  1. #1
    Default steroid induced diabetes
    Medical Coding Books
    I would like to know how you are coding steroid induced diabetes. I know that it was once coded as 251.8 but with the secondary diabetes section 249 I would think this is what is used. Also using the index takes you to secondary diabetes. I am looking in a study book for 2010 that still says to use 251.8. What are your thoughts? Thanks

  2. #2
    I have a 2010 Ingenix book at the moment that leads me to 249.0, specifically. Diabetes, steroid induced in the alphabetic directs you to See Diabetes, Secondary, which is associated with 249.0. In the tabular, 249.0 is Secondary diabetes mellitus without mention of complication (or manifestation classifiable to 249.1-249.9):
    Secondary diabetes NOS
    And there's also a note underneath that says "Drug/chemical induced diabetes mellitus w/o comp", but that may be unique to this ICD-9 publication.

    I don't believe that 251.8 gives the indication that the patient has diabetes, or what caused it. Almost every other code in the Other Disorders of Pancreatic Internal Secretion (251) section specifically exclude glycemic conditions associated with diabetes, which makes me think that the section is devoted to non-diabetic diseases that happen to mimic diabetic symptoms, but I could be wrong.

    The study books aren't always kept up to date with the code changes - it just depends on when the edition is released. It would be really difficult to update them every year, I suppose. The one I used to study for the CPMA exam was the recommended version until this year, and it still had references to CPT 90772, which changed to 96372 in 2009. Trust your code books. The tests are updated annually.

  3. #3
    Columbia, MO
    Go to the ICD-9 guidelines and the section there on secondary diabetes will tell you to code it as a 249.x code.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Thank you. I am studying for my CCS-P and an AHIMA 2010 study guide seems to be very outdated. It concerns me that a study guide to help you prepare would have these simple errors in it. Thanks.

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