1. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. THE COMPLETE DIAGNOSIS CODING SOLUTION THIRD EDITION Chapter 7 Coding Conditions of the Endocrine and Metabolic Systems 7-1

2. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Outcomes 7.1Identify the organs included in the endocrine system. 7.2 Discern between type 1, type 2, secondary, and gestational diabetes mellitus. 7.3 Apply the guidelines for coding diabetic manifestations and co- morbidities. 7-2

3. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Outcomes (cont.) 7.4 Correctly code the use of insulin and insulin pumps. 7.5 Abstract encounter notes to determine the involvement of hormones in certain malignancies. 7.6Determine the impact of an individual’s weight on his or her health. 7-3

4. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms Adrenal glands Cushing’s syndrome Diabetes mellitus Dyslipidemia Endocrine system 7-4

5. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms (cont.) Gestational diabetes mellitus (GDM) Hyperglycemia Hypoglycemia Hypothalamus Hypothyroidism 7-4

6. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms (cont.) Ovaries Pancreas Parathyroid glands Pineal gland Pituitary gland 7-5

7. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms (cont.) Polydipsia Polyuria Secondary Testes Thymus gland 7-6

8. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms (cont.) Thyroid gland Type 1 Type 2 7-6

9. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Introduction The endocrine system consists of all the organs and tissues responsible for creating and secreting hormones and controlling metabolic activity. Learning Outcome: 7.1 7-9

10. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. The Endocrine System Consists of glands located throughout the body, from the head to the genitals: - Hypothalamus - Pituitary gland - Pineal gland - Thyroid gland - Learning Outcome: 7.1 7-10

11. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. The Endocrine System (cont.) Consists of glands located throughout the body (cont): - Parathyroid glands - Thymus Gland - Adrenal Glands - Pancreas Learning Outcome: 7.1 7-11

12. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Disorders of the Endocrine System Diabetes Mellitus (DM) Chronic disease Result of insulin deficiency or resistance Body has a difficult time metabolizing carbohydrates, proteins, and fats Learning Outcome: 7.2 7-12

13. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Diabetes Mellitus Approximately 16 million people have diabetes mellitus 4 Types: –type 1 DM –type 2 DM –secondary DM –gestational DM Learning Outcome: 7.2 7-13

14. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Diabetes Mellitus (cont.) Type 1 DM Sudden onset of insulin deficiency May occur at any age but most often arises in childhood and adolescence Also known as –insulin-dependent diabetes mellitus (IDDM) –juvenile diabetes 7-14

15. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Diabetes Mellitus (cont.) Type 2 DM Gradual onset May develop at any age Most often occurs in adults over the age of 40 Also known as: –non-insulin dependent diabetes mellitus (NIDDM) Learning Outcome: 7.2 7-15

16. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Diabetes Mellitus (cont.) Secondary DM is caused by medications or another condition or disease. Gestational DM is usually temporary and occurs during pregnancy. Learning Outcome: 7.2 7-16

17. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Diabetic Manifestations Due to its involvement with the blood system as well as muscle and fat tissue, DM can cause serious manifestations to develop. Ophthalmic manifestations Neurologic manifestations Renal manifestations Circulatory manifestations Learning Outcome: 7.3 7-17

18. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Long-Term Insulin Use When a patient with type 2 diabetes uses regular insulin, code also + Z79.4 Long-term (current) use of insulin Do not use this code with an individual diagnosed with type 1 diabetes. Learning Outcome: 7.4 7-18

19. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Hyperglycemia/Hypoglycemia Hyperglycemia: Abnormally high glucose levels Hypoglycemia: Abnormally low glucose levels Learning Outcome: 7.4 7-19

20. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Functional Activity of Hormones in Neoplasms When a gland has been found to have a neoplasm (tumor), whether it is benign or malignant, an additional code is necessary to identify the functional activity. The functional activity identifies that the gland is secreting hormones in abnormal quantities. Learning Outcome: 7.5 7-20

21. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Insulin Pumps Underdose due to malfunction of pump T85.614* Breakdown (mechanical) of insulin pump Overdose due to malfunction of pump T85.614* Breakdown (mechanical) of insulin pump Learning Outcome: 7.5 7-21

22. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Diabetes Insipidus Disorder of water metabolism as a result of an antidiuretic hormone (ADH) deficiency Also known as pituitary diabetes insipidus Coded using E23.2 Learning Outcome: 7.5 7-22

23. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Weight Factors Overweight means weighing too much. Obesity indicates a body mass index of 30 to 38.9. Morbid obesity is diagnosed when a patient’s current overweight status interferes with daily activities. Underweight means weighing too little. Learning Outcome: 7.6 7-23

24. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Body Mass Index A calculation using an individual’s actual weight and current height Ranges are different for adults and children –Z68 Body Mass Index [BMI] –Z68.5* Body Mass Index [BMI] pediatric Learning Outcome: 7.6 7-24

25. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Thyroid Disorders Hypothroidism –Thyroid converts energy more slowly than normal –Causes weight gain and fatigue Hyperthyroidism –Also known as overactive thyroid –Causes unexplained weight loss, rapid heart rate, and sensitivity to heat 7-22 Learning Outcome: 7.6

26. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chapter Summary The glands of the endocrine system produce and release various types of hormones that are used by numerous organs throughout the body—all a part of the function of a healthy body. 7-26