Per the ICD-10 guidelines, there is no presumed causal relationship between diabetes and hypertension, so these should be coded as E11.9 and I10 unless the provider documents that one is caused by the other. The presence of the term 'with', when it appears in ICD-10, requires the coder to presume a relationship (unless documented otherwise) but not when this term appears in the medical record. I do not interpret 'associated with' to mean 'caused by' or 'due to', although different organizations may have their own internal guidance to this effect.Need assistance,
There is some discussion in trying to find correct HCC diagnosis for the following:
whether a provider documents, HTN associated with DM or visa versa, would correct DX be E11.59 and I15.2? HELP!
This is one of biggest debates on how they interpret " associated with ". Because the coding will be different. I see many HCC coders do interpret as meaning " caused by" or " due to ". I would like to say I do no interpret the same. Associated and due to are two different meanings, right!?Per the ICD-10 guidelines, there is no presumed causal relationship between diabetes and hypertension, so these should be coded as E11.9 and I10 unless the provider documents that one is caused by the other. The presence of the term 'with', when it appears in ICD-10, requires the coder to presume a relationship (unless documented otherwise) but not when this term appears in the medical record. I do not interpret 'associated with' to mean 'caused by' or 'due to', although different organizations may have their own internal guidance to this effect.
Yes, I agree with you, 'associated' means 'related to', but not necessarily 'caused by', and I think it's a somewhat ambiguous term. But the only way to know for sure what is intended by this wording would be to ask the providers since they're the ones writing it, and different providers may been using these terms in slightly different ways. So I think this is an example of an instance where it's important for an organization to have some kind of a policy as to how this is going to be interpreted, and the providers would need to be involved in developing that policy so they can give their input on what exactly they mean in the documentation and also have an understanding of how their coders are interpreting their words.This is one of biggest debates on how they interpret " associated with ". Because the coding will be different. I see many HCC coders do interpret as meaning " caused by" or " due to ". I would like to say I do no interpret the same. Associated and due to are two different meanings, right!?
Appreciate your feedback. Thank you so much. I'm so glad we have these forums.
I understand that in the alpha index the with guideline can't be presumed; however, if the quote above is documented by the physician then wouldn't that be the linkage verbiage?HTN associated with DM