# DM w/ HTN



## cmedina969800 (Dec 20, 2017)

Hey fellow coders!

We recently had a visit from a document trainer/coder from Optum, and she mentioned that if a patient has DM w/ HTN should be coded as E11.59 and I10.

Is everyone doing this? 

What are your thoughts?


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## blaza192 (Dec 21, 2017)

The ICD-10-CM classifies all "I" codes as circulatory diseases. E11.59 is the code for Type 2 diabetes mellitus with other circulatory complications, so it makes sense. You can't make the assumed relationship for diabetes and hypertension though, which I assume you know.




In audits I see, coder's use either E11.59 or E11.69. I would personally go with E11.59.


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## cmedina969800 (Dec 22, 2017)

blaza192 said:


> The ICD-10-CM classifies all "I" codes as circulatory diseases. E11.59 is the code for Type 2 diabetes mellitus with other circulatory complications, so it makes sense. You can't make the assumed relationship for diabetes and hypertension though, which I assume you know.
> 
> 
> 
> ...



Thank you for the response! It is greatly appreciated. I would like to verify the last part. My understanding with the newer guidelines is that IF the index says "with" it is now presumed that they are linked even if the provider does not state so in the documentation. Would that be fair to say that this would fall in that category?


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## blaza192 (Dec 22, 2017)

You are correct. If the term falls under "with" in the index, we can apply an assumed relationship; however, hypertension is not under "with" for diabetes. 



Go to diabetes and then with. You'll see all the conditions there where assumed relationship can apply with some exceptions.


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## OregonCindi (Dec 22, 2017)

*HTN is "other circulatory"*



blaza192 said:


> You are correct. If the term falls under "with" in the index, we can apply an assumed relationship; however, hypertension is not under "with" for diabetes.
> 
> 
> I understand where both of you are coming from, but I keep going back to the fact that "Other circulatory complications" IS under "with" for diabetes, and hypertension is a circulatory disease. Therefore, E11.59 includes hypertension.....
> ...


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## blaza192 (Dec 22, 2017)

OregonCindi said:


> blaza192 said:
> 
> 
> > You are correct. If the term falls under "with" in the index, we can apply an assumed relationship; however, hypertension is not under "with" for diabetes.
> ...


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## OregonCindi (Dec 26, 2017)

Thank you for that link; somehow I missed that article in my research prior to posting, but that is the information I was looking for and I wanted to see it in writing. ICD-10 is saying that IF the doctor links DM and a circulatory disease other than angiopathy, then E11.59 is where it would go. 

Lol on the periodontal disease btw  point taken.

Cindi, CPC-A


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## cmedina969800 (Dec 26, 2017)

blaza192 said:


> OregonCindi said:
> 
> 
> > Luckily, this was clarified by the coding clinic: http://www.hiacode.com/education/codingtips/coding-tip-cellulitis-and-dm-coding/
> ...


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