"Insulin-dependent" distinctions are no more Providers may find it easier to assign diabetes ICD-9 codes (250-250.9) now that beta cell function drives your determination of both type I and type II diabetes. To take advantage of the new codes, a physician should determine how well a patient's pancreatic beta cells function to distinguish between the diabetes codes' fifth digits, says Beth Fisher, medical systems specialist with the National Center for Health Statistics in Hyattsville, MD. Type I diabetes is relatively rare compared to type II. "Statistics demonstrate that only 5 to 10 percent of all diabetics have type I diabetes," which is an autoimmune disorder, says Alison Nicklas, director of education and training for Precyse Solutions, based in King of Prussia, PA. The tendency of coders and physicians to inaccurately over-report type I diabetes diagnoses based on insulin dependence is therefore wrong both for an individual patient and for the overall diabetic population, she adds. Define diabetes based on beta cell function: As of Oct. 1, doctors should separate the two types of diabetes and choose the fifth digits using two methods:
Physicians now use insulin and non-insulin designations to determine whether patients have type I or type II diabetes -- but the problem with the current system is that physicians often assign a type I diabetes diagnosis to any patient who takes insulin, even though many type II patients use insulin also. That's why the code descrip-tors' deleted insulin designation is a good change that should alleviate a lot of confusion for physicians and coders, Fisher says.
What to expect: