Home Health ICD-9/ICD-10 Alert

Question: How do I know when a condition is a manifestation of diabetes? For example, the physician says our patient has "diabetes with peripheral vascular disease (PVD)." Can I assume that the PVD is the result of our patient's diabetes?

Answer: If the physician indicates in the documentation that diabetes causes the condition, you may consider whether it should be coded as a manifestation. For diabetes with PVD, list 250.70 (Diabetes with peripheral circulatory disorders; type II or unspecified type, not stated as uncontrolled) and 443.81 (Peripheral angiopathy in diseases classified elsewhere).

If, however, the physician documents diabetes and PVD without linking the two, report these conditions with 250.00 (Diabetes mellitus without mention of complication; type II or unspecified type, not stated as uncontrolled) and 443.9 (Peripheral vascular disease, unspecified). Sequence these codes according to the focus of care.