skeene
New
If HTN, CKD, and DM are documented. Can you link HTN to CKD and DM or does it have to be linked to just one if not specifically documented as due to one or the other.
Ok, so wait---even if the 'link' to these chronic conditions are not mentioned/documented, you're saying to still link them?
I think you are confused. The provider does not need to document diabetic CKD or hypertensive CKD and in most cases they do not. So the question was if the documentation states CKD and also indicates HTN and indicates diabetes do you link the CKD to both. The answer is yes CKD is automatically causal to diabetes and also to HTN. If the provider does not want these conditions to be linked then the provider must document for instance that the CKD is NOT due to the diabetes.My understanding is that it all depends on the ICD code description and whether or not the word "with" and/or "and" is part of the description. For diagnosis that contain the words "with" or "and" there does not have to be a documented relationship. If the formal ICD description does not contain "with" and/or "and", and cause/effect must be documented.
The problem is, or what makes coding CKD confusing to me is, that the instructions say 'first code any associated": Diabetic CKD, Hyertensive CKD
which is fine if your patient is diabetic patient with Diabetic CKD or your patient is hypertensive with Hypertensive CKD BUT
what about a diabetic patient with hypertensive CKD or a hypertensive patient with Diabetic CKD
or a diabetic patient with hypertension secondary to their diabetes and then develops CKD secondary to their secondary hypertension.
I sat down, just last night and made myself a cheat sheet but haven't used it at work yet because I was worried I'm overthinking this..........................
Let's discuss.........................![]()