June 7, 2018
With the implementation of ICD-10-CM and coding classification changes, there are now combination codes for diabetes and its associated conditions.
It’s essential that medical records provide specific details on all diabetes-related conditions. Specific coding ensures that you’re accurately reflecting your patients’ health and supports your reimbursement.
When reviewing Diabetes Mellitus (DM) with patients, remember to document and code the following:
- Type 1 (E10.-)
- Type 2 (E11.-)
- Due to underlying condition (E08.-)
- Drug or chemical induced (E09.-)
- Other Specified (E13.-)
- Gestational Diabetes (O24.-)
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- Cause
- Clearly document the cause of diabetes if applicable
- Complications
- Indicate the conditions complicating diabetes to the highest specificity
- Example: Type 2 DM with kidney complications, CKD 4
- If a patient has multiple complications, select a code from Diabetes section for each complication
- Scenario: A patient has type 2 DM with neuropathy, nephropathy and right heel ulcer (with necrosis of muscle) complications.
- Codes:
- E11.40 Type 2 DM with diabetic neuropathy, unspecified
- E11.21 Type 2 DM with diabetic nephropathy
- E11.621 Type 2 DM with foot ulcer
- L97.413 Non-pressure chronic ulcer of right heel with necrosis of muscle
- Indicate hyperglycemia or hypoglycemia when DM is uncontrolled
- There is no code for “uncontrolled” in ICD-10
Review the Premera Documentation and Coding Series for Practitioners. For documentation and coding training or if you have any questions, email ProviderClinical Consulting@Premera.com.