kfrey
Contributor
Need tips on remembering how to sequence diabetes codes and complications associated with diabetes codes
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Wiki Sequencing Difficulty
- Thread starter kfrey
- Start date
Cortzea
Contributor
Tips !!
First thing you have to remember is that DM has lots of complications, especially if the pt had it for a long time ( dont forget to code for Insulin use v58.67 only if they use it every day) I usually ask myself :
1.-Does this pt has nerve damage (usually peripherally damage ) ?
2.-Did this pt get CKD due to DM2 ,Hypertension or Both ?
( 250.4_ , 403.__, CKD stage .....)
If diabetes is uncontrolled it will most likely have renal complications, nerve damage, ophthalmic complications and in worst cases unhealed wounds .. so when you see diabetes.. remember eyes, renal,nerve, wounds.. i hope i didnt make too hard for you. let me know if you need more help
First thing you have to remember is that DM has lots of complications, especially if the pt had it for a long time ( dont forget to code for Insulin use v58.67 only if they use it every day) I usually ask myself :
1.-Does this pt has nerve damage (usually peripherally damage ) ?
2.-Did this pt get CKD due to DM2 ,Hypertension or Both ?
( 250.4_ , 403.__, CKD stage .....)
If diabetes is uncontrolled it will most likely have renal complications, nerve damage, ophthalmic complications and in worst cases unhealed wounds .. so when you see diabetes.. remember eyes, renal,nerve, wounds.. i hope i didnt make too hard for you. let me know if you need more help
Last edited:
tag60
Guru
I think your best bet is just to read the chapter guidelines in the front of your coding book. Then, with enough practice you will eventually remember what to sequence first. It's just a matter of doing it enough, but anytime you're unsure, the guidelines are where you will find your answers.
For diabetes, check the Chapter-Specific Coding Guidelines in the front of your coding book for Chapter 3 (Endocrine, etc.), under "assigning and sequencing diabetes codes and related conditions." This has a great explanation. Also, when you look up the diabetes code itself, look for instructions to "code first, "code also," "code additional." These tell you if you need other codes and the sequence (e.g., "code also" means that code would go after). So pay close attention to the instructions above the code. Make it a habit to always check if there are instructions; again, soon you will become familiar enough to know what to do without having to look it up each time.
There are also general guidelines before the chapter guidelines that cover "etiology/manifestation conventions." I must admit, when I first started coding, the guidelines seemed wordy and boring and didn't always make sense to me. I've come to see them now, however, as the first place to check when I have a question.
I'm not sure if this answer is quite what you were looking for/asking about. If you have a specific example (a certain condition with your diabetes), post that and we'll help out.
For diabetes, check the Chapter-Specific Coding Guidelines in the front of your coding book for Chapter 3 (Endocrine, etc.), under "assigning and sequencing diabetes codes and related conditions." This has a great explanation. Also, when you look up the diabetes code itself, look for instructions to "code first, "code also," "code additional." These tell you if you need other codes and the sequence (e.g., "code also" means that code would go after). So pay close attention to the instructions above the code. Make it a habit to always check if there are instructions; again, soon you will become familiar enough to know what to do without having to look it up each time.
There are also general guidelines before the chapter guidelines that cover "etiology/manifestation conventions." I must admit, when I first started coding, the guidelines seemed wordy and boring and didn't always make sense to me. I've come to see them now, however, as the first place to check when I have a question.
I'm not sure if this answer is quite what you were looking for/asking about. If you have a specific example (a certain condition with your diabetes), post that and we'll help out.
jorzano55@gmail.com
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Just beware ICD10 is going to change everything we know and remember about coding Diabetes with manifestations, complications, controlled vs uncontrolled, and insulin use. Like the saying goes, just when you learn the game they change the rules.
kfrey
Contributor
Any tips on sequencing Diabetes in ICD-10
mitchellde
True Blue
Most of the diabetes with complications codes are coded as only one code. When an additional code is required like with foot ulcer to are told to add it and from which section to select. Example E10.21 type 1 with diabetic neuropathy needs no other code for this condition, E10.22 type 1 with chronic kidneys disease instructs you to add an N18.- code for the stage, in that case the N18.- code is secondary.
kfrey
Contributor
A patient with Diabetes and diagnosed with Peritoneal Cancer plus Liver Cancer; what would be coded first in ICD 10
mitchellde
True Blue
It will depend on what is being treat and is the diabetes due to the Cancer. Documentation will drive the order of the codes , the guidelines will tell you how to code the sequencing based on the documentation.