Question: Apatient presents for foot care due to diabetes complications. The patient was a diabetic for over 30 years but recently had a pancreas transplant that rendered him "cured" of the diabetes. The physician notes that diabetes caused the patient's foot problem, but I'm not sure if I can use a diabetes diagnosis codes for a patient who no longer has the disease.
Idaho Subscriber
Answer: After having diabetes for 30 years, a patient may certainly have residual diabetic complications. Although a pancreas transplant normalizes a patient's blood glucose levels and essentially "cures" the diabetes, the transplant won't repair previous damage to the body. So, if your physician treats a pancreas transplant patient, you should code the patient's diabetic complications with both the diabetes complication code and the specific code for the given condition.
For example, for a patient with foot problems caused by diabetic peripheral circulatory disorders, you might report 250.7x. You may also consider assigning a code for the patient's transplant status (V42.83, Organ or tissue replaced by transplant; pancreas). You should not report a basic diabetes code, such as 250.03 (Diabetes mellitus without mention of complication; type I, uncontrolled). This would be inaccurate because the patient no longer has diabetes, only the diabetic complications.
Not always cured: The patient may still have diabetes mellitus following a pancreatic transplant, regardless of whether he has diabetic complications. You should code the patient's diabetic condition according to what the endocrinologist documents in the chart.
