halled67@gmail.com
Contributor
If you have a patient that is diagnosis Diabetes and Peripheral Vascular Disease. Can you assume the relationship and use code E11.51?
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Wiki Assumed relationships with Diabetes
- Thread starter halled67@gmail.com
- Start date
With ICD-10 the relationship between the codes is considered "casual" and can be assumed.
Munzueta
Guru
Hello,
yes this is the actual guideline.
The word “with” or “in” should be interpreted to mean “associated with” or “due
to” when it appears in a code title, the Alphabetic Index, or an instructional note in
the Tabular List. The classification presumes a causal relationship between the
two conditions linked by these terms in the Alphabetic Index or Tabular List.
These conditions should be coded as related even in the absence of provider
documentation explicitly linking them, unless the documentation clearly states
the conditions are unrelated or when another guideline exists that
specifically requires a documented linkage between two conditions.
So for instance, if you go to your ICD-10-CM index, look for diabetes, you will see the first subterm you have after is "with" meaning all the conditions under the main term diabetes>with can be coded with the appropriate combination code even when the physician doesn't specify.
If the physician says "this patient has a DMII........also patient comes in with hyperglycemia" then you will be able to use the combination code of DM2 with hyperglycemia even if the physician didn't link it.
hope this clarifies your concern
yes this is the actual guideline.
The word “with” or “in” should be interpreted to mean “associated with” or “due
to” when it appears in a code title, the Alphabetic Index, or an instructional note in
the Tabular List. The classification presumes a causal relationship between the
two conditions linked by these terms in the Alphabetic Index or Tabular List.
These conditions should be coded as related even in the absence of provider
documentation explicitly linking them, unless the documentation clearly states
the conditions are unrelated or when another guideline exists that
specifically requires a documented linkage between two conditions.
So for instance, if you go to your ICD-10-CM index, look for diabetes, you will see the first subterm you have after is "with" meaning all the conditions under the main term diabetes>with can be coded with the appropriate combination code even when the physician doesn't specify.
If the physician says "this patient has a DMII........also patient comes in with hyperglycemia" then you will be able to use the combination code of DM2 with hyperglycemia even if the physician didn't link it.
hope this clarifies your concern