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The question is about DM/W manifestations
250.70 Diabetes TypeII W Periph vasc dis
586 Renal failure
401.9 Hypertension nos controlled
250.40 diabetes typeII W renal manifestations
You do have to reveiw the documents to see if the renal was due to the DM or the HTN or maybe not, if it does indicate this in the document you must use the DM code along with one of the options listed below in the ICD-9 book, or if it indicates renal disease with the HTN. This is why you must look through the documentation to help clarify how it was indicated within the chart so you know which codes you are using. Just thought I would throw my two cents in to help you to understand why if was referred to you to look back through the document and what you want to be looking for. Hope this helps.
We are auditing the records from a medical group and they either under code or up code. The pt came in for a routine check up. Nothing special was done on that visit. The confusion came in from if we can link the 250.40 with the 586(renal failure) because we are linking the HTN 403.90 with this.
You only link the renal failure to the HTN if it is chronic kidney disease (any code form the 585 category) or when documented by the physician. so a 586 cannot be auto linked with the HTN, and you cannot auto link the 586 with the diabetes this must be documented by the physicna as being due to or causal to the diabetes. This is why I indicated to see what the documentation stated.
This is all from the coding guidelines.