Diabetes

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  • 1. Diabetes Practice Liaison Program (DPL) Coding Diabetes MellitusCoding Diabetes Mellitus
  • 2. Introduction · Diabetes mellitus is a very dangerous disease that affects as many as 16 million Americans. It is one of the leading causes of death by disease. · There are four types: Type 1, Type 2, Gestational, and Other.
  • 3. Diabetes Mellitus · Type 1 Diabetes: · Insulin-dependent diabetes (IDDM) · Juvenile diabetes · Can occur at any age · Occurs suddenly
  • 4. Diabetes Mellitus · Type 2 Diabetes: · Non-insulin-dependent diabetes (NIDDM) · Can occur at any age but most often in adults over the age of 40 · Occurs gradually
  • 5. Diabetes Mellitus · Gestational Diabetes Mellitus (GDM): · Usually a temporary condition occurring during pregnancy · Can increase risk of developing diabetes later
  • 6. Hyper/Hypoglycemia · Hyperglycemia: Abnormally high glucose levels · Hypoglycemia: Abnormally low glucose levels
  • 7. Coding Diabetes · Once a patient has been diagnosed with diabetes mellitus: · All codes require FIVE digits: 250.xx · Almost always reported because diabetes is a systemic disease
  • 8. Coding Diabetes Diabetes with manifestations will always require at least TWO codes: · First, the diabetes code: 250.xx · Second, the manifestation code
  • 9. Coding Diabetes Diabetes Mellitus: Code category 250 · Fourth Digit (250.xx) will identify the manifestation, if any. · For example: · 250.0x No manifestation · 250.4x Renal manifestation 12 - 9
  • 10. Coding Diabetes Fifth Digit (250.xx) will identify the current status of the diabetes. · The specific type of diabetes: Type 1 or type 2 · Does the documentation specifically state uncontrolled? 12 - 10
  • 11. Coding Sequence · Diabetes Code (250.xx): Always listed before any manifestation code · If not the reason for the encounter, list the diabetes code after the codes for the reason.
  • 12. Insulin Use · When a patient with type 2 diabetes uses regular insulin, code also: · + V58.67 Long-term (current) use of insulin · Do not use this code with an individual diagnosed with type 1 diabetes.
  • 13. Insulin Pumps · Underdose due to malfunction of pump OR · Overdose due to malfunction of pump · Add code: 996.57 Mechanical complication of other specified prosthetic device, implant, and graft, due to insulin pump
  • 14. Diabetes Insipidus · Diabetes Insipidus: Disorder of water metabolism; also known as pituitary diabetes insipidus