Reader Question: Stay Away From 250.xx for Secondary Diabetes

Question: What is the appropriate ICD-9 code for a patient with diabetes mellitus due to a Whipple procedure?

Virginia Subscriber

Answer: The correct code for this patient's condition is 251.3 (Postsurgical hypoinsulinemia).

The Whipple procedure is a surgical procedure physicians use to treat pancreatic cancer by removing the head of the pancreas as well as parts of other nearby organs and tissues. Following a complete or partial pancreatectomy, a patient may develop hypoinsulinemia, which is exactly what code 251.3 indicates.

The patient's condition is, by definition, diabetes mellitus. However, you should never use diabetes codes from the 250.xx series (Diabetes mellitus) to report secondary diabetes (diabetes caused by another problem or outside factor).