Question: When I'm choosing the type of diabetes, at what age is the patient considered to be an adult instead of a juvenile? Does the patient's age even matter?
California Subscriber
Answer: Typically, you don't have to use a patient's age to determine whether you diagnosis a patient with either Type I or Type II diabetes mellitus (250.xx). To pick the right diabetes type, make sure you know each type's definition and Medicare's requirements for diagnosis.
Type I diabetes is an autoimmune disease that destroys the pancreas' beta cells and leads to insulin deficiency. Type II is familial hyperglycemia that occurs primarily in adults but can also occur in children and adolescents. This form of diabetes results from an insulin resistance with a multiple etiology and is not totally understood. Gestational diabetes is any degree of glucose intolerance with onset or first recognition during pregnancy.
The terms "adult-onset" and "juvenile" are fairly irrelevant when determining which type of diabetes a patient has, because people of all ages can be diagnosed with Type II diabetes (adult-onset type). When in doubt, query your physician to be sure you are assigned the correct diagnosis. And inform your endocrinologists they need to document the patient's type of diabetes in the medical record.
- The answers to the Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC, MA, an ob-gyn coding expert based in Fredericksburg, Va.; Anita M. Carr, CPC, business office manager and assistant practice manager for Endocrine and Diabetes Associates in Louisville, Ky.; Judy Richardson, MSA, RN, CCS-P, senior consultant with Hill & Associates in Wilmington, N.C.; Shelley Wojtasczyk, MS, FNP-C, a nurse practitioner in a family medicine clinic in Arcade, N.Y.; and Alison Nicklas, RHIT, CCS, director of education and training for Precyse Solutions, based in King of Prussia, Pa.
