Primary Care Coding Alert

Question: The physician indicated the patient has diabetes complicated by peripheral neuropathy. I'm not sure whether he needs to state "autonomic peripheral neuropathy" in order to choose the correct diagnosis. Should we report 250.6x, 337.1 or 250.6x, 357.2?

Florida Subscriber

Answer: First, you are correct that the primary diagnosis should be 250.6x (Diabetes with neurological manifestations). The instructions under this code direct you to use an additional code to identify manifestations. Both 337.1 (Peripheral autonomic neuropathy in disorders classified elsewhere) and 357.2 (Polyneuropathy in diabetes) are among the possible manifestations listed. Unfortunately, a simple notation of "peripheral neuropathy" is not enough information to allow you to choose between the two codes. Therefore, follow up with the physician and clarify with him which of these codes best describes the peripheral neuropathy indicated.