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

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a 40-year-old patient was diagnosed with

diabetes malius type type 2 with

diabetic neuropathy due to acute

pancreatis or

pancreatitis patient is not insulin

dependent but is temporarily on insulin

to control the blood

sugar all right

coders which

guideline are you going to use

your time begins

now

you are doing an amazing job selecting

the correct guideline

amazing anybody want to try and coat

it it might take a little longer huh you

need more time than that but the most

important thing is that you recognize

the guideline you put your eyes on it

and understand it all right so what I'm

going to do is I'm going to highlight my

key

terms this is diabetes malius type two

with diabetic neuropathy due to

acute

pancreatitis

right and the patient is not insulin

dependent but temporarily on

insulin and you all said the guideline

that you would use is C4

A6 secondary

diabetes remember secondary

diabetes is due to a system IC or other

problem and if you look down below it

says diabetes due to an underlying

condition um diabetes or drug or

chemical induced diabetes or other

specified diabetes our case we have

diabetes due to an underlying condition

so we have diabetes

mtis with diabetes neuropathy due to

acute app

acute pancrea

pancrea

pancreatitis all right so it's due to

the acute

pancreatitis or

pancreatis that's the underlying

condition and my

advice follow your instructional notes

when you're coding

secondary

diabetes follow your instructional notes

that um sequencing order that we have

here it's good but your instructional

notes will take

precedence follow those instructional

notes write that in your MCG manual we

um the editor that we had last time

thought that maybe we should take it out

I don't think we should we need need

that guidance so make sure that you

follow your instructional notes write it

in it will be in the MCG in

2024 all right so we have some key

things going on we know that the

underlying condition is acute

pancreatitis or

pancreatis whatever you want to call it

and we also know that the insulin that

the patient was using was temporary so

we have

guidelines right so let's look at our

well we've already looked at the

guidelines for secondary diabetes and

the sequencing order but please follow

your instructional notes it won't stare

you wrong and then you have C4

a6a and this is

um when you are coding for temporary

insulin when you how to code for

temporary insulin in other words you

don't code temporary insulin all right

so we know we're not going to code that

now this is how you code for secondary

diabetes and the index is going to prove

very very helpful this is how you do

it and we have diabetes due to an

underlying condition the underlying

condition is acute pancreatitis or

pancreatis

and now I'm going to look it up

diabetes due to I'm going to bypass this

with and also too I use these guiding

lines if it's see how diabetes sticks

out we know that's the main term and

then we're going down we're going to

bypass with and we're going to go to do

to Du to an underlying

condition with we're not going to

actually code the underlying condition

yet but due to an underlying condition

with what with diabetic neuropathy so

let's go down and let's look

for

neuropathy

e8.4 and this is our default

code

now let's go to the tabular

list and let's go ahead and verify

e8.4

e08 boss diabetes metis due to

underlying condition and if you look

underneath it says code

first the underlying condition you got

to code first that underlying condition

we said it was acute pancreatitis and

let's look down and see

and there you

go all right so it's giving us some

examples look at that ours is right

there but we know that

e8.4 is secondary diabetes militis so

let's go ahead and finish coding it out

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e8.4 diabetes malius to due to

underlying condition

with diabetic neuropathy unspecified so

you see how this code is a combination

code this diabetes code it includes the

type of

Diabetes right it also includes the

neuropathy it's this is truly truly a

granual code all right so we've got our

secondary diabetes code we also are

looking at our instructional notes which

tells us to code first the underlying

condition and the underlying condition

is the pancreatitis or

pancreatis all

right so let's go ahead and code it

let's look it up

k85 .9 we can't code that there's a red

box and look it says

pancreatitis

Nos and if we look at k85 90 this is

acute

pancreatitis without necrosis or

infection

unspecified so that is our code indeed

so this code will be sequenced first

based upon the

guidance k85.90

followed by

e8.4 and we are not going to code the

insulin because this insulin is or was

temporary okay coders are you with me

somebody said hey I got

it and somebody said hey I'm here yes I

see you I'm glad you're

here okay I got one got it how do you

feel somebody said hey I got it again

somebody said I need some practice this

all right I want to know we have you

know our class is you know an average

siiz class I need a few more I need to

know how you're doing okay somebody else

said I got

it because I don't want to just talk to

one or two

people I got to talk to most of the

people all right so at the onset of

class somebody said hey I'm not too too

sure about secondary

diabetes I got another one for you okay

and remember

remember pay attention to those

instructional notes they will guide

you we don't want to do

that all right which codes best describe

the encounter

a TA

5.64 wait am I in the right one let me

just make sure

okay

yeah I

am T8 5.64 t38

383 x6a