Internal Medicine Coding Alert
Remember Primary Diagnosis Code for These Diabetics
Question: I am coding a claim for which the notes indicate that the nonphysician practitioner (NPP) provided an E/M service for an established patient with "secondary diabetes w/ renal manifest." Do I have enough information to choose a diagnosis code with these notes?
Michigan Subscriber
Answer: You have enough there to choose 249.40 (Secondary diabetes mellitus with renal manifestations; not stated as uncontrolled or unspecified) for the patient's secondary diabetes.
To paint a complete diagnosis picture for these patients, however, you also need to code the associate condition. Solet's say that the patient's diabetes was caused by Kimmelstiel-Wilson syndrome. On the claim, you'd report the following:
249.40 to represent the patient's secondary diabetes;
581.81 -- Nephrotic syndrome; with other specified pathological lesion in kidney; nephrotic syndrome in diseases classified elsewhere, to represent the Kimmelstiel-Wilson syndrome.
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