# 790.21



## heatherwinters (Aug 2, 2012)

If a patient had previous abnormal glucose levels but now the lab values are normal, can a clinician continue to use the 790.21 code in his assessment to justify further follow up?  

My thought is no.  You must code based on what you know to be true at the time of reporting and currently the examination of the blood is normal.  790.21 is used to report an abnormal finding on examination of blood - impaired fasting glucose.  If the fasting glucose is normal, the assessment is no longer justified.

The clinicians I work with feels that 790.21 is an abnormality of the metabolic/endocrine system that results in elevated glucose levels which do not yet approach those of diabetes.  

Would V12.29 be appropriate in this scenario or perhaps 790.29 - but even then if lab values are now normal I don't know that is justified.


----------



## kumeena (Aug 2, 2012)

I heard from somewhere which I do not remember now that you can coed either f/up along with monitoring Diagnosis (V67.59 & 790.29 in this case) or you can code only follow up. History is not appropriate especially if other risk factors are still present (Obese, Family HX, etc.,)

I would like to hear from others opinion in this .


----------



## rhondatalley (Aug 19, 2012)

If the patient previously had abnormal findings and the new testing is to establish whether they have returned to normal, I would code the abnormal findings code as that is the reason for the encounter.  One example that we encounter frequently is an abnormal mammogram with no documented diagnosis.  793.89 is used for the diagnosis in this case because the abnormal findings for the initial mammogram establish the reason for the follow up radiology services.


----------



## jbrightw (Aug 21, 2012)

790.21 itself is not a definite diagnosis but a sign of diabetes and the patient visits for the same and the values are normal now. Without an abnormality we cannot code it, hence V12.29 is appropriate.

Brightwin


----------



## mitchellde (Aug 21, 2012)

V12.29 is not appropriate as an isolated elevated glucose reading on a non fasting test is not a disease of blod forming organs.  The patient had a random blood test which showed an elevated reading, a fasting test was then ordered to see if this was a random non fasting result.  The result was a normal sugar, therfore the fasting is either a screening for diabetes or a follow up, and the more I think about this , the patient meets the criteria for screening so I would go with screening for diabetes.


----------



## jbrightw (Aug 22, 2012)

V12.29 is not a Hx of disease of blood forming organs but V12.29 is 'Other *endocrine*, metabolic, and immunity disorders'

In this case the patient had an elvated fasting glucose but not now. No other symptoms mentioned. It may be a screening for diabetes but it is not evident in the indication. Hence it is appropriate to use V12.29 in the absence of present abnormality.

Hope this makes sense

Brightwin


----------



## mitchellde (Aug 22, 2012)

it does not state abnormal fasting blood sugar, she states that the patient had previous abnormal levels and now the fasting result is normal.  she states that if it were an abnormal fasting result she would use the 790.xx.  But as I said just having abnormal blood sugar reading does not give you a hx of having an endocrine metabolic or immunity disorder.  (apologize for the mis category in previous post).   No more than an isolated low blood count gives you a hx of leukemia.


----------

