Home Health ICD-9/ICD-10 Alert

Code diabetes with ophthalmic manifestations as primary, because the patient was admitted due to her diabetic retinopathy, explains Laresa Boyle, director of coding services at Longview, TX-based Healthcarefirst. The physician did not identify the diabetes as uncontrolled, so use a fifth digit of "0." Then code the hypertension and visual loss. Had this patient been on insulin, you would have added V58.67 (Long-term [current] use of insulin), she notes.



Question 2: Mr. J. is a patient with Type 2 diabetes who fell and broke his hip. During his recovery, he developed bilateral heel ulcers. He was treated at a wound care center, but his ulcers worsened. He had a sharp debridement of the right heel, but later developed osteomyelitis. He is receiving home care for wound vac to the right heel following a calcanectomy and care for the remaining decubitus on the left heel. How would you code this episode?

Answer: Code the following:

In this case, the diabetes and its manifestation would go in M0240 because the diabetic osteomyelitis is still an active diagnosis and in M0245 because you need to use a V code in M0230, Boyle explains.