bmanus
Guru
Good morning,
Can anyone tell me what codes require the 362. codes as the primary code?
Can anyone tell me what codes require the 362. codes as the primary code?
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- Thread starter bmanus
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AlaskanCoder
Guru
Not exactly sure what you are asking, but let me take a stab at this.
Under the category of 362, there is the subcategory of 362.0x which is for Diabetic retinopathy. In the tabular list under the subcategory of 362.0 there is an ICD-9-CM convention telling the coder to "Code first diabetes (249.5, 250.5)". If the retinopathy is a manifestation of diabetes, then diabetes is coded before the manifestation code. If the retinopathy or other retinal disorder coded to category 362 is not due to diabetes, then this rule does not apply.
There is no time that 362 is "required" to be the primary code (principal or first listed diagnosis) - that would be determined by the ICD-9-CM guidelines for selecting the principal or first listed diagnosis. If, for instance, the primary reason for the encounter was senile cataracts (366.16) and the patient also had diabetic macular edema which was also medically managed in the encounter, then you would code first 366.16 followed by 250.5X and then 362.07.
Does that make sense and does it answer your question?
Karen Hill, CPC, CPB, CPMA
AHIMA Approved ICD-10-CM Trainer
Under the category of 362, there is the subcategory of 362.0x which is for Diabetic retinopathy. In the tabular list under the subcategory of 362.0 there is an ICD-9-CM convention telling the coder to "Code first diabetes (249.5, 250.5)". If the retinopathy is a manifestation of diabetes, then diabetes is coded before the manifestation code. If the retinopathy or other retinal disorder coded to category 362 is not due to diabetes, then this rule does not apply.
There is no time that 362 is "required" to be the primary code (principal or first listed diagnosis) - that would be determined by the ICD-9-CM guidelines for selecting the principal or first listed diagnosis. If, for instance, the primary reason for the encounter was senile cataracts (366.16) and the patient also had diabetic macular edema which was also medically managed in the encounter, then you would code first 366.16 followed by 250.5X and then 362.07.
Does that make sense and does it answer your question?
Karen Hill, CPC, CPB, CPMA
AHIMA Approved ICD-10-CM Trainer
annawade13
Networker
This might not be what you're referring to, but I recently read that the PQRS codes for measures 18 and 19 are only counted if you code 362.xx as the primary code (which flies in the face of everything we learn in coding school.) Obviously the 249.xx or 250.xx still has to be in the record and on the payable codes.
http://www.aoa.org/news/practice-management/how-one-pqrs-diabetes-code-can-save-you-future-penalties
"Only link measures No. 18 and 19 to the applicable diabetic retinopathy codes. Do not link the 2021F to the systemic diabetic diagnosis or to the macular edema diagnosis."
http://www.aoa.org/news/practice-management/how-one-pqrs-diabetes-code-can-save-you-future-penalties
"Only link measures No. 18 and 19 to the applicable diabetic retinopathy codes. Do not link the 2021F to the systemic diabetic diagnosis or to the macular edema diagnosis."