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Diagnosis sequencing for nail problem of a diabetic patient

  1. #1
    Default Diagnosis sequencing for nail problem of a diabetic patient
    Medical Coding Books
    If a patient is referred to podiatry for foot care and the patient is diabetic, which diagnosis code would be primary? The diabetes or the corns/callos, foot ulcer or nail issue?

  2. #2
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    if the foot problem is documented as a manifestation ofthe diabetes then the diabetes is coded first with the appropriate 4th digit other that 0. If it is not documented as causal to the diabetes then the diabetes is listed second with a 4th digit of 0.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Per Medicare FT 001 Billing/Coding Guidelines: "Report the ICD-9 code for which the service(s) is performed in the first position in the diagnosis field of the CMS 1500 claim form or electronic equivalent; report the systemic condition(s) in the remianing positions." As Medicare goes, so goes the rest, usually. Check the internet for payer specific rules as they pertain to podiatry. There are benefits and rules specific to this specialty. Hope this helps.

  4. #4
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    Quote Originally Posted by Audrey49 View Post
    Per Medicare FT 001 Billing/Coding Guidelines: "Report the ICD-9 code for which the service(s) is performed in the first position in the diagnosis field of the CMS 1500 claim form or electronic equivalent; report the systemic condition(s) in the remianing positions." As Medicare goes, so goes the rest, usually. Check the internet for payer specific rules as they pertain to podiatry. There are benefits and rules specific to this specialty. Hope this helps.
    Yes and when documentation supports that the problem is a manifestation of the diabetes then that IS the reason for the encounter and the sppropriate diabetes code is sequenced first. Per coding guideline

    Debra A. Mitchell, MSPH, CPC-H

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