Wiki Sequencing changes my primary Dx?

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Provider note states End Stage Renal Disease as Dx but according to Guidelines, I need to "Code first any associated: diabetic chronic kidney disease" (E11.22 is what I need to code, and further instruction for sequencing).
My question is, because of sequencing, then my primary code will be for E11.22 -Diabetes Mellitus II (with Z79.84 - Oral Antidiabetic Drug) then, I12.0 - Hypertension with CKD/ESRD, and finally N18.6 - End Stage Renal Disease (with Z99.2 Hemo Dependent)? That's how I'm understanding my guidelines.
Thank you in advance!
 
If the patient has CKD due to diabetes then yes, E11.22 then I12.0, N18.6, Z99.2 (if they have started dialysis) and Z79.84 if applicable. If there is no documentation that the CKD is related to the diabetes (diabetes is an incidental dx) then I12.0, E11.22, N18.6, Z99.2 (again if they have started dialysis) and Z79.84 if applicable. ICD 10 presumes if the patient has hypertension and CKD hypertension is the cause. It does not have the same presumption for diabetes.
 
michellepilcher said:
If the patient has CKD due to diabetes then yes, E11.22 then I12.0, N18.6, Z99.2 (if they have started dialysis) and Z79.84 if applicable. If there is no documentation that the CKD is related to the diabetes (diabetes is an incidental dx) then I12.0, E11.22, N18.6, Z99.2 (again if they have started dialysis) and Z79.84 if applicable. ICD 10 presumes if the patient has hypertension and CKD hypertension is the cause. It does not have the same presumption for diabetes.
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Actually ICD-10 does presume a relationship between diabetes and chronic kidney disease. If you look in the alpha section under the key word Diabetes, you will see the term "with". Any diagnosis then indented under the word "with" is an auto presumed relationship with the diabetes.
Therefore the original post is correct in the diagnosis codes and the listing order.
 
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