250.00 - Unspecified Diabetes is going away!
Also, controlled and uncontrolled diabetes, no longer will matter for coding purposes (but are probably still valuable from a clinical standpoint).
So what's new?
All the new concepts are easy and make sense:
- Type of Diabetes: 1 or 2 or secondary (yes it exists in ICD-10)
- Cause (drug or chemical induced)
- Complications. example renal or neurologic
ICD-10 CM diabetes codes are combination codes.
(Complications included in the code description)
Ex: E10.10 type 1 diabetes mellitus with ketoacidosis, without coma
E11.9 is the new diabetes code
You’ll notice the code itself specifies type 1 diabetes. Unlike ICD-9-CM, type 1 and type 2 diabetes have their own code categories in ICD-10-CM. We would use E11.9 for a type 2 diabetic with no complications. E11.9 also serves as our default diabetes code, replacing 250.00.
We also need to report Sativa’s long-term insulin use. In ICD-9-CM, we use V58.67. In ICD-10-CM, we’ll use Z79.4.
Our second diabetic patient, Helen, is not doing as well. Helen is a type 2 diabetic who has had several toes amputated because of her diabetes and currently suffers from a foot ulcer caused by her diabetes.
ICD-10-CM diabetes codes include detailed information about the specific complication caused by the patient’s diabetes. In Helen’s case, we would report E11.621 (type 2 diabetes mellitus with foot ulcer).
We also need to report an additional code to identify the site of the ulcer (L97.4-, L97.5-). Don’t worry about forgetting that detail. The “use additional code” note appears directly under E11.621.
L97.4- and L97.5- both denote chronic non-pressure ulcers. Use L97.4- for ulcers on the heel and midfoot. For the rest of the foot, use L97.5-. Both categories include laterality, so we need to know which foot is affected.
In addition to knowing where on the foot the ulcer is, we also need to know the ulcer’s severity. L97.4- and L97.5- classify ulcers as:
And don’t forget Z79.4 if Helen uses insulin.
Our final diabetic for the day is Jim, who suffers from Cushing’s syndrome as well as diabetes. Dr. Needle documents that his Cushing’s syndrome caused his diabetes. Jim’s diabetes also caused stage 2 chronic kidney disease.
We see a lot of cause and effect and underlying conditions in Jim’s case. Fortunately, ICD-10-CM provides us with instructional notes on what to code and what order to report the codes. If we look up diabetes due to an underlying condition, a note under code category E08 tells us to code first the underlying condition.
That means our first code is for Jim’s Cushing’s syndrome. In order to code that, we need to know the cause of the Cushing’s. Our choices include:
E08.22 also tells us we need a code for the stage of the chronic kidney disease. Since we know Jim’s chronic kidney disease is stage 2, we would add code N18.2 (chronic kidney disease, stage 2 [mild]).
Diabetes coding in ICD-10-CM will take some getting used to, but at least we won’t have to query for controlled or uncontrolled any more.
- See more at: http://blogs.hcpro.com/icd-10/#sthash.ZpdZSPPO.dpuf
Also, controlled and uncontrolled diabetes, no longer will matter for coding purposes (but are probably still valuable from a clinical standpoint).
So what's new?
All the new concepts are easy and make sense:
- Type of Diabetes: 1 or 2 or secondary (yes it exists in ICD-10)
- Cause (drug or chemical induced)
- Complications. example renal or neurologic
ICD-10 CM diabetes codes are combination codes.
(Complications included in the code description)
Ex: E10.10 type 1 diabetes mellitus with ketoacidosis, without coma
E11.9 is the new diabetes code
Our
beloved (and much used) ICD-9-CM code 250.00 (unspecified diabetes) is
going away soon - See more at:
http://blogs.hcpro.com/icd-10/#sthash.ZpdZSPPO.dpuf
@50Our
beloved (and much used) ICD-9-CM code 250.00 (unspecified diabetes) is
going away soon - See more at:
http://blogs.hcpro.com/icd-10/#sthash.ZpdZSPPO.dpuf
- Type of diabetes (I or II or secondary)
- Cause of the disease (drug or chemical induced, due to underlying condition)
- Body system chronic complications (e.g., kidney or neurological complications)
- Other specific complications (e.g., foot ulcer)
- E10.10, type 1 diabetes mellitus with ketoacidosis without coma
- E10.11, type 1 diabetes mellitus with ketoacidosis with coma
You’ll notice the code itself specifies type 1 diabetes. Unlike ICD-9-CM, type 1 and type 2 diabetes have their own code categories in ICD-10-CM. We would use E11.9 for a type 2 diabetic with no complications. E11.9 also serves as our default diabetes code, replacing 250.00.
We also need to report Sativa’s long-term insulin use. In ICD-9-CM, we use V58.67. In ICD-10-CM, we’ll use Z79.4.
Our second diabetic patient, Helen, is not doing as well. Helen is a type 2 diabetic who has had several toes amputated because of her diabetes and currently suffers from a foot ulcer caused by her diabetes.
ICD-10-CM diabetes codes include detailed information about the specific complication caused by the patient’s diabetes. In Helen’s case, we would report E11.621 (type 2 diabetes mellitus with foot ulcer).
We also need to report an additional code to identify the site of the ulcer (L97.4-, L97.5-). Don’t worry about forgetting that detail. The “use additional code” note appears directly under E11.621.
L97.4- and L97.5- both denote chronic non-pressure ulcers. Use L97.4- for ulcers on the heel and midfoot. For the rest of the foot, use L97.5-. Both categories include laterality, so we need to know which foot is affected.
In addition to knowing where on the foot the ulcer is, we also need to know the ulcer’s severity. L97.4- and L97.5- classify ulcers as:
- Limited to breakdown of skin
- With fat layer exposed
- With necrosis of muscle
- With necrosis of bone
- With unspecified severity
And don’t forget Z79.4 if Helen uses insulin.
Our final diabetic for the day is Jim, who suffers from Cushing’s syndrome as well as diabetes. Dr. Needle documents that his Cushing’s syndrome caused his diabetes. Jim’s diabetes also caused stage 2 chronic kidney disease.
We see a lot of cause and effect and underlying conditions in Jim’s case. Fortunately, ICD-10-CM provides us with instructional notes on what to code and what order to report the codes. If we look up diabetes due to an underlying condition, a note under code category E08 tells us to code first the underlying condition.
That means our first code is for Jim’s Cushing’s syndrome. In order to code that, we need to know the cause of the Cushing’s. Our choices include:
- E24.0, pituitary-dependent Cushing’s disease
- E24.1, Nelson’s syndrome
- E24.2, drug-induced Cushing’s syndrome
- E24.3, ectopic ACTH syndrome
- E24.4, alcohol-induced pseudo-Cushing’s syndrome
- E24.8, other Cushing’s syndrome
- E24.9, Cushing’s syndrome, unspecified
E08.22 also tells us we need a code for the stage of the chronic kidney disease. Since we know Jim’s chronic kidney disease is stage 2, we would add code N18.2 (chronic kidney disease, stage 2 [mild]).
Diabetes coding in ICD-10-CM will take some getting used to, but at least we won’t have to query for controlled or uncontrolled any more.
- See more at: http://blogs.hcpro.com/icd-10/#sthash.ZpdZSPPO.dpuf
Our
beloved (and much used) ICD-9-CM code 250.00 (unspecified diabetes) is
going away soon. In fact, the whole idea of controlled or uncontrolled
diabetes won’t matter either for coding purposes in ICD-10-CM. Instead,
we’ll need to know:
You’ll notice the code itself specifies type 1 diabetes. Unlike ICD-9-CM, type 1 and type 2 diabetes have their own code categories in ICD-10-CM. We would use E11.9 for a type 2 diabetic with no complications. E11.9 also serves as our default diabetes code, replacing 250.00.
We also need to report Sativa’s long-term insulin use. In ICD-9-CM, we use V58.67. In ICD-10-CM, we’ll use Z79.4.
Our second diabetic patient, Helen, is not doing as well. Helen is a type 2 diabetic who has had several toes amputated because of her diabetes and currently suffers from a foot ulcer caused by her diabetes.
ICD-10-CM diabetes codes include detailed information about the specific complication caused by the patient’s diabetes. In Helen’s case, we would report E11.621 (type 2 diabetes mellitus with foot ulcer).
We also need to report an additional code to identify the site of the ulcer (L97.4-, L97.5-). Don’t worry about forgetting that detail. The “use additional code” note appears directly under E11.621.
L97.4- and L97.5- both denote chronic non-pressure ulcers. Use L97.4- for ulcers on the heel and midfoot. For the rest of the foot, use L97.5-. Both categories include laterality, so we need to know which foot is affected.
In addition to knowing where on the foot the ulcer is, we also need to know the ulcer’s severity. L97.4- and L97.5- classify ulcers as:
And don’t forget Z79.4 if Helen uses insulin.
Our final diabetic for the day is Jim, who suffers from Cushing’s syndrome as well as diabetes. Dr. Needle documents that his Cushing’s syndrome caused his diabetes. Jim’s diabetes also caused stage 2 chronic kidney disease.
We see a lot of cause and effect and underlying conditions in Jim’s case. Fortunately, ICD-10-CM provides us with instructional notes on what to code and what order to report the codes. If we look up diabetes due to an underlying condition, a note under code category E08 tells us to code first the underlying condition.
That means our first code is for Jim’s Cushing’s syndrome. In order to code that, we need to know the cause of the Cushing’s. Our choices include:
E08.22 also tells us we need a code for the stage of the chronic kidney disease. Since we know Jim’s chronic kidney disease is stage 2, we would add code N18.2 (chronic kidney disease, stage 2 [mild]).
Diabetes coding in ICD-10-CM will take some getting used to, but at least we won’t have to query for controlled or uncontrolled any more.
- See more at: http://blogs.hcpro.com/icd-10/#sthash.ZpdZSPPO.dpuf
Type of diabetes (I or II or secondary)
- Cause of the disease (drug or chemical induced, due to underlying condition)
- Body system chronic complications (e.g., kidney or neurological complications)
- Other specific complications (e.g., foot ulcer)
- E10.10, type 1 diabetes mellitus with ketoacidosis without coma
- E10.11, type 1 diabetes mellitus with ketoacidosis with coma
You’ll notice the code itself specifies type 1 diabetes. Unlike ICD-9-CM, type 1 and type 2 diabetes have their own code categories in ICD-10-CM. We would use E11.9 for a type 2 diabetic with no complications. E11.9 also serves as our default diabetes code, replacing 250.00.
We also need to report Sativa’s long-term insulin use. In ICD-9-CM, we use V58.67. In ICD-10-CM, we’ll use Z79.4.
Our second diabetic patient, Helen, is not doing as well. Helen is a type 2 diabetic who has had several toes amputated because of her diabetes and currently suffers from a foot ulcer caused by her diabetes.
ICD-10-CM diabetes codes include detailed information about the specific complication caused by the patient’s diabetes. In Helen’s case, we would report E11.621 (type 2 diabetes mellitus with foot ulcer).
We also need to report an additional code to identify the site of the ulcer (L97.4-, L97.5-). Don’t worry about forgetting that detail. The “use additional code” note appears directly under E11.621.
L97.4- and L97.5- both denote chronic non-pressure ulcers. Use L97.4- for ulcers on the heel and midfoot. For the rest of the foot, use L97.5-. Both categories include laterality, so we need to know which foot is affected.
In addition to knowing where on the foot the ulcer is, we also need to know the ulcer’s severity. L97.4- and L97.5- classify ulcers as:
- Limited to breakdown of skin
- With fat layer exposed
- With necrosis of muscle
- With necrosis of bone
- With unspecified severity
And don’t forget Z79.4 if Helen uses insulin.
Our final diabetic for the day is Jim, who suffers from Cushing’s syndrome as well as diabetes. Dr. Needle documents that his Cushing’s syndrome caused his diabetes. Jim’s diabetes also caused stage 2 chronic kidney disease.
We see a lot of cause and effect and underlying conditions in Jim’s case. Fortunately, ICD-10-CM provides us with instructional notes on what to code and what order to report the codes. If we look up diabetes due to an underlying condition, a note under code category E08 tells us to code first the underlying condition.
That means our first code is for Jim’s Cushing’s syndrome. In order to code that, we need to know the cause of the Cushing’s. Our choices include:
- E24.0, pituitary-dependent Cushing’s disease
- E24.1, Nelson’s syndrome
- E24.2, drug-induced Cushing’s syndrome
- E24.3, ectopic ACTH syndrome
- E24.4, alcohol-induced pseudo-Cushing’s syndrome
- E24.8, other Cushing’s syndrome
- E24.9, Cushing’s syndrome, unspecified
E08.22 also tells us we need a code for the stage of the chronic kidney disease. Since we know Jim’s chronic kidney disease is stage 2, we would add code N18.2 (chronic kidney disease, stage 2 [mild]).
Diabetes coding in ICD-10-CM will take some getting used to, but at least we won’t have to query for controlled or uncontrolled any more.
- See more at: http://blogs.hcpro.com/icd-10/#sthash.ZpdZSPPO.dpuf
.Our
beloved (and much used) ICD-9-CM code 250.00 (unspecified diabetes) is
going away soon. In fact, the whole idea of controlled or uncontrolled
diabetes won’t matter either for coding purposes in ICD-10-CM. Instead,
we’ll need to know:
You’ll notice the code itself specifies type 1 diabetes. Unlike ICD-9-CM, type 1 and type 2 diabetes have their own code categories in ICD-10-CM. We would use E11.9 for a type 2 diabetic with no complications. E11.9 also serves as our default diabetes code, replacing 250.00.
We also need to report Sativa’s long-term insulin use. In ICD-9-CM, we use V58.67. In ICD-10-CM, we’ll use Z79.4.
Our second diabetic patient, Helen, is not doing as well. Helen is a type 2 diabetic who has had several toes amputated because of her diabetes and currently suffers from a foot ulcer caused by her diabetes.
ICD-10-CM diabetes codes include detailed information about the specific complication caused by the patient’s diabetes. In Helen’s case, we would report E11.621 (type 2 diabetes mellitus with foot ulcer).
We also need to report an additional code to identify the site of the ulcer (L97.4-, L97.5-). Don’t worry about forgetting that detail. The “use additional code” note appears directly under E11.621.
L97.4- and L97.5- both denote chronic non-pressure ulcers. Use L97.4- for ulcers on the heel and midfoot. For the rest of the foot, use L97.5-. Both categories include laterality, so we need to know which foot is affected.
In addition to knowing where on the foot the ulcer is, we also need to know the ulcer’s severity. L97.4- and L97.5- classify ulcers as:
And don’t forget Z79.4 if Helen uses insulin.
Our final diabetic for the day is Jim, who suffers from Cushing’s syndrome as well as diabetes. Dr. Needle documents that his Cushing’s syndrome caused his diabetes. Jim’s diabetes also caused stage 2 chronic kidney disease.
We see a lot of cause and effect and underlying conditions in Jim’s case. Fortunately, ICD-10-CM provides us with instructional notes on what to code and what order to report the codes. If we look up diabetes due to an underlying condition, a note under code category E08 tells us to code first the underlying condition.
That means our first code is for Jim’s Cushing’s syndrome. In order to code that, we need to know the cause of the Cushing’s. Our choices include:
E08.22 also tells us we need a code for the stage of the chronic kidney disease. Since we know Jim’s chronic kidney disease is stage 2, we would add code N18.2 (chronic kidney disease, stage 2 [mild]).
Diabetes coding in ICD-10-CM will take some getting used to, but at least we won’t have to query for controlled or uncontrolled any more.
- See more at: http://blogs.hcpro.com/icd-10/#sthash.ZpdZSPPO.dpuf
- Cause of the disease (drug or chemical induced, due to underlying condition)
- Body system chronic complications (e.g., kidney or neurological complications)
- Other specific complications (e.g., foot ulcer)
- E10.10, type 1 diabetes mellitus with ketoacidosis without coma
- E10.11, type 1 diabetes mellitus with ketoacidosis with coma
You’ll notice the code itself specifies type 1 diabetes. Unlike ICD-9-CM, type 1 and type 2 diabetes have their own code categories in ICD-10-CM. We would use E11.9 for a type 2 diabetic with no complications. E11.9 also serves as our default diabetes code, replacing 250.00.
We also need to report Sativa’s long-term insulin use. In ICD-9-CM, we use V58.67. In ICD-10-CM, we’ll use Z79.4.
Our second diabetic patient, Helen, is not doing as well. Helen is a type 2 diabetic who has had several toes amputated because of her diabetes and currently suffers from a foot ulcer caused by her diabetes.
ICD-10-CM diabetes codes include detailed information about the specific complication caused by the patient’s diabetes. In Helen’s case, we would report E11.621 (type 2 diabetes mellitus with foot ulcer).
We also need to report an additional code to identify the site of the ulcer (L97.4-, L97.5-). Don’t worry about forgetting that detail. The “use additional code” note appears directly under E11.621.
L97.4- and L97.5- both denote chronic non-pressure ulcers. Use L97.4- for ulcers on the heel and midfoot. For the rest of the foot, use L97.5-. Both categories include laterality, so we need to know which foot is affected.
In addition to knowing where on the foot the ulcer is, we also need to know the ulcer’s severity. L97.4- and L97.5- classify ulcers as:
- Limited to breakdown of skin
- With fat layer exposed
- With necrosis of muscle
- With necrosis of bone
- With unspecified severity
And don’t forget Z79.4 if Helen uses insulin.
Our final diabetic for the day is Jim, who suffers from Cushing’s syndrome as well as diabetes. Dr. Needle documents that his Cushing’s syndrome caused his diabetes. Jim’s diabetes also caused stage 2 chronic kidney disease.
We see a lot of cause and effect and underlying conditions in Jim’s case. Fortunately, ICD-10-CM provides us with instructional notes on what to code and what order to report the codes. If we look up diabetes due to an underlying condition, a note under code category E08 tells us to code first the underlying condition.
That means our first code is for Jim’s Cushing’s syndrome. In order to code that, we need to know the cause of the Cushing’s. Our choices include:
- E24.0, pituitary-dependent Cushing’s disease
- E24.1, Nelson’s syndrome
- E24.2, drug-induced Cushing’s syndrome
- E24.3, ectopic ACTH syndrome
- E24.4, alcohol-induced pseudo-Cushing’s syndrome
- E24.8, other Cushing’s syndrome
- E24.9, Cushing’s syndrome, unspecified
E08.22 also tells us we need a code for the stage of the chronic kidney disease. Since we know Jim’s chronic kidney disease is stage 2, we would add code N18.2 (chronic kidney disease, stage 2 [mild]).
Diabetes coding in ICD-10-CM will take some getting used to, but at least we won’t have to query for controlled or uncontrolled any more.
- See more at: http://blogs.hcpro.com/icd-10/#sthash.ZpdZSPPO.dpuf
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