# coding for patients with diabetes



## Colliemom (Apr 20, 2009)

When billing for patients with Type 2 Diabetes we need to add on the V58.67 as a secondary dx to specify that the patient is insulin dependent.  If all patients with Type 1 Diabetes are insulin dependent, then do we still need to add on the V58.67 to specify insulin dependence?


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## Anna Weaver (Apr 20, 2009)

*coding for type 1*

That's a good question. My thinking is that since taking insulin is inherent to Type I diabetes, you should not have to code for the insulin dependence, but since in Type II, not everyone is insulin dependent, that's what this code was designed for. I think in the case of Type I, V58.67 would be a redundant code.


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## Colliemom (Apr 21, 2009)

I thought it would be redundant also.  But, I seem to be getting mixed answers to this question.


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## Anna Weaver (Apr 21, 2009)

*coding for diabetes*

I'm not surprised you are getting mixed answers. I have found that whenever there is not a specific direction, it's left open for interpretation and not everyone is going to interpret it the same. Good luck!


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## nilewis (Apr 11, 2014)

*type 2*

My provider is telling me that her type 2 patients are converting to type 1 How do you code for this ??? I'm very confused and don't see anything that says this is correct.  I was taught that type 2 who becomes insulin dependent you code the 250.00 with the V58.67 code to show the use of insulin..Help


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## mitchellde (Apr 11, 2014)

nilewis said:


> My provider is telling me that her type 2 patients are converting to type 1 How do you code for this ??? I'm very confused and don't see anything that says this is correct.  I was taught that type 2 who becomes insulin dependent you code the 250.00 with the V58.67 code to show the use of insulin..Help



 Type 2 diabetes cannot progress or convert to type 1. I ran into this with a provider a few years ago and his rationale was he understood that when a type 2 patient became insulin dependent then they had converted or progressed to a type 1. This is absolutely not true, and I had to go to several medical textbooks and physiology definitions before I convince him that this is in fact incorrect. Is this the reason your provider is saying this? You cannot change a patient's diabetes type just to make certain services pay. However you can indicate type 2 with insulin dependence by appending the V58.67
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