Wiki Coding diabetes with neuropathy and gastroparesis

[medcode1]

I am being told that if documentation has diabetes with neuropathy (E11.40) and diabetes with gastroparesis (E11.43), then E11.43 is the higher specificity and only code that (I do risk adjustment). I thought neuropathy and gastroparesis were two different diagnosis therefore both would be coded. Can anyone please confirm the correct way to code these diagnosis when found in the same note and why it should be coded that way?

 

[thomas7331]

I would agree that it would not be correct to code an unspecified and a specified condition at the same time. If the record shows that the patient has more than one form of neuropathy, then each of them may be coded, but if only one form is specified, it would be contradictory to also code that the patient has an additional manifestation but that it is not specified.

In other words, to report two codes, the record needs to support that there are two distinct conditions that exist, which cannot be the case if one of them is not sufficiently specified to distinguish it from the other. Since diabetic gastroparesis is a form of neuropathy, it's not clear from the information you've given here whether the patient has additional forms of neuropathy or not unless there is more specificity elsewhere in the record.