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Diabetes diagnosis

  1. Question Diabetes diagnosis
    Medical Coding Books
    If the diagnosis is DKA (250.10) would you also use 250.01 (diabetes mellitus type 1)?

  2. Default
    Quote Originally Posted by kmelling View Post
    If the diagnosis is DKA (250.10) would you also use 250.01 (diabetes mellitus type 1)?
    Is the patient type 1 or type 2? In the first dx you have it is for type 2 or unspecified, but in the second you say it is type one. It IS going to be 250.1x depending on if it is type 1 or type 2 or unspecified and also depending on whether controlled or uncontrolled or not specified. Also if the patient is in a coma, that also changes the code. So need more information to correctly answer your question.

  3. #3
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    I agree! You also cannot code a 250.1x with a 250.0x because a fourth digit of 0 indicates non complicated and they cannot be non complicated and then also have complications at the same encounter. more information will aid us in assisting you further.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default
    Diabetic ketoacidosis (DKA) is coded 250.13, diabetes with ketoacidosis type I [juvenile type],uncontrolled. It is uncontrolled by definition. Code 250.13 is the default, unless the physicianspecifically documents type II.

  5. #5
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    The coding guidelines specify that diabetes is coded as type II unless specified by the physician. While it happens predominantly in those with type 1 diabetes, it can occur in those with type 2 diabetes under certain circumstances. So one cannot automatically assume diabetic ketoacidosis is type 1, without adequate documentation we must follow the guidelines and code it as type II.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    Diabetic ketoacidosis (DKA) is coded 250.13, diabetes with ketoacidosis type I [juvenile type],
    uncontrolled. It is uncontrolled by definition. Code 250.13 is the default, unless the physician
    specifically documents type II. Prior to 7/15/06, DKA was coded 250.11, unless specifically
    identified as NIDD (250.10). (See Coding Clinic, second quarter 2006, pages 19 and 20, and
    Coding Clinic, third quarter 1991, pages 6 and 7.)

  7. #7
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    I would have to disagree even with the AHA on this one. I do not have access to either of those issues of the Coding Clinic so I am unable to see the context in which they wrote that statement. From the American diabetes association:
    "Ketoacidosis may happen to anyone with diabetes, though it is rare in people with type 2."
    So while it is more common in those with type 1, we cannot assume this and I still feel that the guidelines must be followed and we will default to type 2.

    Debra A. Mitchell, MSPH, CPC-H

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    I love that spirit. Thank you Mitchelle!

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    Thank you Mitchelld

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