Home Health ICD-9/ICD-10 Alert

Question: We have patients with diabetes and severe circulatory disorders such as peripheral vascular disease (PVD), but the doctor's documentation and dictation do not mention it as a manifestation of diabetes. Can I assume that PVD is manifestation of diabetes and code it as such, or do I need to specifically have physician documentation that states the disorder is a manifestation?

Illinois Subscriber

Answer: There are only two manifestations that ICD-9 coding guidelines assume are manifestations of diabetes: gangrene and osteomyelitis.

If the patient has diabetes and either (or both) gangrene or osteomyelitis, you may assume that they are manifestations of diabetes unless physician documentation states otherwise. Although diabetes is a major cause of peripheral vascular disease and angiopathy, you may not assume a connection. Ask for verification from the physician.