ICD-10-CM Specific Coding Guidelines - Endocrine Part IV

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but after a neuromuscular

exam filament test and nerve conduction

studies the patient diagnosed with

diabetic

neuralgia a

e11.42

z79.4 b

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e1042

r2.0

m79.604

m79.605 c

e13 42 and d e

10.42 a Pati patient with type 1

diabetes on insulin presents with

complaints of numbness and tingling in

her feet and burning in her extremities

she also gets sharp pains in her legs at

night and then after that neuromuscular

exam filament test and nerve conduction

study the patient's diagnosed with

diabetic neuralgia

coders do your thing and solve this

scenario your time begins

now

okay coders the time is almost up and I

notice no one referenced the guidelines

so you got this do we have a guideline

for this I think we do but a general one

outstanding outstanding outstanding all

right so everyone you know everyone said

something different so let's see see how

we solve this we know this is type one

diabetes metis look at a just saying all

right on

insulin okay look at a just saying with

complaints of numbness tingling in the

feet and burning in her extremities and

she has sharp pains at night she's been

diagnosed with diabetic

neuralgia all right coders sounds like

those signs and symptoms are integral to

the by diabetic

neuralgia all right so I'm going to use

my

index and I'm going to look up diabetes

diabetes type one

right

with

neuralgia and it takes us to

e1042 next

I'm a verify

e10.5 type 1 diabetes with neurologic

complications and then if I scroll down

to e1. 42 this is type 1 diabetes with

diabetic poly neuropathy and right up

underneath

that type 1 diabetes metis with diabetic

neuralgia same

meaning so that is our code

e1042 and we have a guideline and the

guideline says

hey these codes are combination codes

and also don't code any insulin with

this so we're going to get rid of

c c is the wrong category we're going to

get rid of B because they're coding

signs and symptoms integral

to a disease and they're not we you know

that's a combination code no point in

coding the um

integral items and then a is coding for

type

two our answer

D and so what you do is you go to the

diabetes and the index right here here's

your

instruction book up type

one with neural

and that's how you get your answer and

feel free to look up to to review this

playback you're going to get more the

next time you see it all right so here's

some final things about diabetic codes I

know we took a long time but look at

type one just look at it remember

there's one one in type one right type

two there's two

ones type one you do not code insulin

with it it's

understood type two you

can and all diabetic codes are

combination codes they are if they're

not the non-specific codes they're

combination codes that include the type

of Diabetes type one or two the body

system affected such as kidney and

nerves the complication affecting the

body such as CKD or

neuropathy type two codes for insulin if

the patient is Doc if it's documented

that they're using insulin in type one

you do

not and I think that's

all that's all I think just the more you

do a coders the better you'll

become we're not finished no we're not

finished we have a little more time to

go little more to to review all right so

just want to let you know that obesity

and body mass index is also um in this

chapter in the endocrine chapter or yeah

diseases of the endocrine system so I

just want to let you know that the code

series is e65 the category series is e65

through

e69 and BMI if it's documented it should

be coded as well and they a BMI is

calculated by using the height and

weight and is used um most often because

it correlates with the amount of body

fat that a person has so it's used most

often in integumentary and when you're

coding for it so just want to make you

aware of the Obesity codes code to the

documentation if the provider says the

patient is obese

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so if the documentation says the patient

is morbidly obese

e66.01 if they're overweight you use the

overweight code and you can use the BMI

code z68 the appropriate depending upon

their BMI range

okay and just code to the documentation

don't um try and determine anything if

the doctor does not say the patient is

morbidly obese I don't care if they are

500 lbs we can't code it we code the

documentation if we're able to query

that doctor then we query but we do not

label or diagnose the patient without

the doctor you know we don't diagnose

the patient that is not our um scope of

practice we code to the documentation

and that's it now when you get in the

real world your providers will give you

some instruction but right now we are

students right okay so the um BMI is Z3

z68 category and then you as you can see

the BMI levels are indicated and just

code accordingly it's very

straightforward all right I am

finished and now I want to hand it over

from Mr sandep who's going to end

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things with eyes pain and psych okay Mr

Sandy please and thank

you thanks for tuning in and until next

time happy

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coding