# Need help coding...



## Gemini18 (Sep 23, 2009)

Left great toe ischemia s/p amputation
PVD
ESRD on peritoneal dialysis 
DM 2


Thank you.


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## dclark7 (Sep 24, 2009)

Need more info, s/p amputation of the toe?  When was it amputed?  Are the ischemia, PVD or ESRD complications of the DM?

Doreen, CPC


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## Gemini18 (Sep 24, 2009)

*Help coding*



dclark7 said:


> Need more info, s/p amputation of the toe?  When was it amputed?  Are the ischemia, PVD or ESRD complications of the DM?
> 
> Doreen, CPC




Hi Doreen -

The amputation was done 2/19/09, original DOS 2/17/09.  Here's a quote from the chart -- "The ischemic toe is a combination of peripheral vascular disease as well as neuropathic disease".

I apologize for not including that in the beginning.


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## dclark7 (Sep 30, 2009)

If these conditions are complications of the diabetes you could code this as 250.72 (diabetes type 2 w/peripheral circulatory manifestations), 443.81 (peripheral angiopathy in diseases classified elsewhere), 250.42 (diabetes with renal manifestations), 585.6 (end stage renal disease, because of the dialysis).  If they are not diabetic complications you could use 443.9 (unspecified PVD), 585.6, and 250.00.  Your best bet would be to query the doctor and find out if these are complications or not, you could also ask him if code 440.24 (atherosclerosis of extremities with gangrene) would be appropriate for the ischemic toe.  Hope tis helps a liitle or at least points you in the right direction.

Doreen, CPC


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