Internal Medicine Coding Alert

Coders need to pay special attention to information recorded in the chart to ensure that they use the correct code for diabetes patients.

Some types of diabetes are not coded with the 250.xx series, cautions Karen M. Beard, CPC, a senior associate at Medical Management Associates Inc., in Atlanta. Those include:

Diabetes Insipidus (ICD-9 code 253.5). Less common than diabetes mellitus, this disease is characterized by frequent urination without the abnormal blood or urine glucose levels seen in diabetes mellitus patients, Beard says. "A decrease in a substance known as antidiuretic hormone (ADH), a hormone in the brain, is responsible for the frequent urination," she adds.

Gestational Diabetes (ICD-9 code 648.8x). This form of diabetes occurs during pregnancy and usually resolves on its own after pregnancy. If the physician consults or assists in managing diabetes that develops during pregnancy, be sure to use this code series. "If the diabetes persists after pregnancy, then follow-up care should be coded using the appropriate code for DM from the 250.xx range," Beard says.

Bronzed Diabetes (ICD-9 code 275.0). This rare metabolic disorder, also known as hemochromatosis, is related to the body's absorption of iron and affects mostly men, after age 30, Beard says. Symptoms include diabetes mellitus, a bronze skin color, an enlarged liver and heart failure. "An ICD code from series 250.xx should not be coded as a secondary, even though DM is one of the symptoms," Beard says.