Question: A patient presents to our family practice for foot care due to diabetes complications. The patient was a diabetic for over 30 years but had a pancreas transplant that rendered him "cured" of the diabetes. The family physician notes that diabetes caused the patient's foot problem, but I'm not sure if I can use diabetes diagnosis codes for a patient who no longer has the disease. Answer: After living with diabetes for 30 years, a patient may certainly have residual diabetic complications. Although a pancreas transplant normalizes a patient's blood glucose levels and essentially "cures" the diabetes, the transplant won't repair previous damage to the body. So, if your family physician treats a pancreas transplant patient, you should code the patient's diabetic complications with both the diabetes complication code and the specific code for the given condition.
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For example, if diabetic peripheral circulatory disorders caused your patient's foot problems, you might report 250.7x. You may also consider assigning a code for the patient's transplant status (V42.83, Organ or tissue replaced by transplant; pancreas). You should not report a basic diabetes code, such as 250.03 (Diabetes mellitus without mention of complication; type I, uncontrolled). Because the patient no longer has diabetes, you should only report the diabetic complications.