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abill_423

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Can someone tell me how you would code the following? Diabetes type 2 with nephropathy? Would you code these two things separately 250.00 and 593.9 because it states "with" and not "due to"? Or would you assume a relationship between the 2 and code it as 250.40 and 583.81? We are having a disagreement in my office on how to code this and I would appreciate your input.

Thanks!
 
I would code the 250.40 and 583.81.

The definition of the code is "with" not "due to".

250.4 Diabetes with renal manifestations


Laura, CPC, CEMC
 
I disagree I would go with the 250.00 and the 593.9 because we cannot assume the relationship as coders it must be stated by the physician. Saying with says the two conditions exist not that one is causal to the other.
 
Hi abill, I found something for you in the ICD-9 coding book, should you ever need something in writing to support your deiabtetes and/or manifestation codes. In the ICD-9 book, in the Guidelines, Section I: Conventions, general coding guidelines and chapter specific guidelines, #6, the second to the last paragraph (on page 3 in 2008 version) it states the following:

"The most commonly used etiology/manifestation combinations are the codes for Diabetes mellitus, category 250. For each code under category 250 there is an additional code note for the manifestation that is specific for that particular diabetic manifestation. Should a patient have more than one manifestation of diabetes, more than one code from the 250 category may be used with as many manifestation codes as are needed to fully describe the patient's complete diabetic condition. The category 250 codes should be sequenced first, followd by the manifestation codes."
I know this is too little too late, but it might be helpful for you in future:)
 
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