# Coding Diabetes



## Gemini18 (Aug 25, 2009)

How would you code the following?  They are all on one chart.

Diabetic foot ulcer
DM II insulin uncontrolled           
Diabetic neuropathy


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## mitchellde (Aug 25, 2009)

250.82
250.62
707.15
357.2


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## Gemini18 (Aug 25, 2009)

Thanks Debra -

Would that be considered contractory, with the 250.82 and 250.62?  Just asking


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## mitchellde (Aug 25, 2009)

No it indicates multiple complications, you can have as many of thise as is documented, you just may not have a 250.0x once you have a 4th digit indicating complication


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## hlew (Aug 25, 2009)

diabetic foot ulcer = 250.80, 707.15
DM II insulin uncontrolled = 250.02
diabetic neuropathy = 250.60, 357.2


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## LTibbetts (Aug 26, 2009)

280.52, 280.62, 707.15 & 357.2.

You can use as many diabetes codes as it takes. It is not contractory and it is actually recommended to do so. I was always told that you should use ALL diabetes codes of manifestations from the disease as is documented in the chart.


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## mitchellde (Aug 26, 2009)

hlew said:


> diabetic foot ulcer = 250.80, 707.15
> DM II insulin uncontrolled = 250.02
> diabetic neuropathy = 250.60, 357.2



In your answer, you need to use the fifth digit of 2 since it is stated as uncontrolled therefore: 250.62, not 250.60 and 250.82, not 250.80 codes, also you do not code the 250.02 at all as the fourth digit in that indicates no complication and the documentation supports two complications


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## hthompson (Jan 15, 2010)

mitchellde said:


> In your answer, you need to use the fifth digit of 2 since it is stated as uncontrolled therefore: 250.62, not 250.60 and 250.82, not 250.80 codes, also you do not code the 250.02 at all as the fourth digit in that indicates no complication and the documentation supports two complications



I perfectly agree too 

It would be as stated previously:


250.62
357.2
250.82
707.15

I'm not sure that the exact order means anything as long as the diabetes comes first.  I put mine linked in order.  Diabetic neuropathy with neuropathy code and Diabetic Ulcer with ulcer code.


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## L_Silva CPC (Jan 15, 2010)

I agree, with Heidi,
250.62
357.2
250.82
707.15


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## Jacoder (Jan 18, 2010)

Don't forget the V58.67 for insulin use.


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## hthompson (Jan 26, 2010)

I thought about starting a new thread, but since this thread brought up the question, I thought I'd keep it here:

V58.67 states "Long term (current) use of insulin"

Why would you add that if you don't know how long the pt has been on insulin?  By that term alone, I'd only use it if the provider told me that it was long term.  Is there a definition of what long term means as it pertains to these codes?


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## mitchellde (Jan 26, 2010)

Heidi 
It is long term or current you do not need to know how long, it is for when insulin is prescribed to be used by the patient from this day for a prolonged time frame.  as opposed to a one time dose of insulin being given to a non insulin dependent.


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