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2. Coding Diabetes The physician did not document the type of diabetes!

3. Chapter 3 ICD9 Guidelines 2. Type of diabetes mellitus not documented If the type of diabetes mellitus is not documented in the medical record the default is type II. 250.00

4. 5 th digits in Diabetes 250.02 This code should only be used if the physician states that the diabetes is “uncontrolled”. 250.03 This code should only be used if the physician states that the diabetes is “uncontrolled”.

5. V58.67 This code is for Type II Diabetics only.

6. Coding the Manifestations of Diabetes Chapter 3 Guidelines: When assigning codes for diabetes and its associated conditions, the codes from category 250 must be sequenced first.

7. Diabetic Neuropathy 250.60 357.2

8. Coding HTN Category 401 Category 402 Category 403

9. Talk to your physician about being specific When coding hypertension it’s good to know if it is malignant or benign.

10. 401.9 Unspecified

11. 401.0 Malignant hypertension: Severe high arterial blood pressure that results in the necrosis of the kidneys and the retina.

12. 401.1 Benign: Mildly elevated arterial blood pressure.

13. Hypertensive Chronic Kidney Disease Assign a code from category 403 and category 585 or 587

14. Hypertensive Heart and Chronic Kidney Disease Requires 3 codes

15. Guidelines State: Assign codes from combination category 404, Hypertensive Heart and chronic kidney disease, when both hypertensive kidney disease and hypertensive heart disease are stated in the diagnosis. Assume a relationship between the hypertension and the chronic kidney disease, whether or not the condition is so designated. Assign an additional code from category 428, to identify the type of heart failure. More than one code may be assigned. The appropriate code from category 585 should be used.

16. Elevated BP should not be coded as HTN. Elevated blood pressure: Per the guidelines, “For a statement of elevated blood pressure without further specificity, assign code 796.2, Elevated blood pressure reading without diagnosis of hypertension, rather than a code from category 401.

17. Hypertension Table

18. Coding CKD Category 585

20. There are 5 Stages of CKD Chronic Kidney Disease 585.1 Some kidney damage 585.2 Equates to mild CKD 585.3 Equates to moderate CKD 585.4 Equates to severe CKD

21. Stage 4 585.5 Chronic Kidney failure with a GFR value of less than 15.

22. 585.6 End Stage Renal Disease 585.6 is assigned when the provider has documented end-state-renal disease (ESRD) If both a state of CKD and ESRD are documented, assign code 585.6 only.

23. Review Should V58.67 be used for patients with Type 1 Diabetes?

24. Poorly controlled diabetes is uncontrolled diabetes

25. Dr. Connect has seen Sally for 5 years for HTN. For the last 5 years her diagnosis is 401.9. Is this good or bad? What should be done about it?

26. When is it okay to code 585.6?

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