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

[Music]

ch

[Music]

[Music]

[Music]

ch

[Music]

[Music]

oh

[Music]

[Music]

chapter 4 of icd1

CM code series easy 00 through

e89 they review the following topics

disorders of the thyroid

gland diabetes

mtis other disorders of

glucose

regulation and

pancreatic internal

secretion disorders of endocrine glands

intraoperative complications of the

endocrine system

malnutrition other nutritional

deficiencies

overweight obesity and other

hypernation metabolic diseases and

postprocedural

endocrine

complications and disorders not

elsewhere

classified so it's more than

diabetes but diabetes is where you have

the guidelines that sometimes are not as

straightforward this is where you have

the majority of your guidelines so let's

get into it and let's talk about those

guidelines we I'm sure you all know this

but I'm going to repeat it there are two

types of diabetes you have type one and

type two right

type one is referred to as insulin

dependent diabetes type two non insulin

dep dependent it type one is also

referred to as juvenile

diabetes type one usually occurs early

in life typically in childhood or before

the patient reaches the age of 30

type 1 diabetes patients require insulin

to survive that's why it's called

insulin

dependent type one

diabetes when you're coding for type one

diabetes patient it is already

understood that the

patient has or is taking insulin so you

do not code long-term insulin use

because it's already understood that a

type one patient is taking it so you

don't code it twice in fact the code is

insulin dependent

diabetes the type one code is insulin

dependent so it is inherent in the code

so we're not going to

overcode all right also just remember

adults can have juvenile diabetes

again although it's diagnosed early in

life they have it throughout the life of

the

patient now some key things about type 2

diabetes type 2 diabetic patients still

produce insulin but because of obesity

age or weakness the insulin produced is

not enough to keep their blood sugar

levels within normal limits and these

type two um

patients well this type two diabetes is

the default if the diabetes is not

specified so if a doctor says a patient

has diabetes and you have no way of

querying that doctor and you have to

make a decision like when you're taking

your

exam if the doctor says the patient has

diabetes they are saying they have type

two I'm say it again when the doctor

doesn't specify the type type two is the

default now something else you need to

know about diabetic

codes these are combination codes yes

diabetes codes are generally combination

codes yes we do have the nonspecific

codes

but generally they are combination codes

which indicate the type of diabetes it

indicates the body system affected it

also indicates the

complication affecting that body system

so the type of Diabetes will be

indicated in that code whether it's type

one or

two the body system affected will be

indicated in that code whether it's the

system nerves retina

kidney and the complication will also be

addressed in that combination code and

it will be referred to as diabetic

neuropathy diabetic

retinopathy or

diabetic

neur

nephropathy I always confuse neuropathy

and

nephropathy

neuropathy speak to nerves nephropathy

speaks to the kidney now remember coders

code as many codes that are

suitable to your doc for your

documentation and

sequence as your first

listed the reason for the encounter the

chief reason for the

encounter okay

coders we're going to review some

guidelines and yes if you can follow

along in your MCG

manual chapter

4 let's do

it all right so I didn't ask you how are

you are we good coders you're all doing

good ready to review these

guidelines

good yeah outstanding all

right guideline C4

A1 this guideline speaks to the type of

Diabetes now let me tell you this is a

summary of the diabetes this is um

guidelines this is not the complete

guidelines but a summary and here are

some key things we're pulling out and

some key things you need to

know guideline C4 A1 type of Diabetes

says that age is is not the determining

factor of the type of Diabetes like I

said before an adult can have juvenile

diabetes a child can have type

two so just remember Diabetes Type 1

code is

E10 and this is insulin dependent

diabetes metis and do not assign insulin

with this code because insulin use is

understood type

two the code is

E11

noninsulin dependent diabetes malius

right so the type two does not necessar

um diabetic patients do not necessarily

use insulin that's why it's called

noninsulin dependent diabetes metis and

the documentation has to specify that

the patient is using insulin in order

for you to code it as longterm

use and remember coders if the type of

diabetes is not documented the default

will be type

two next guideline oh and this is

guidelin C4 A1 C4

A2 now next guideline

C4

A3 diabetes and the use of insulin and

oral

hypoglycemics all right so here's the

guideline type of Diabetes not

documented and the patient uses insulin

so let's say you have documentation and

the doctor did not say doctor said the

patient is diabetic but didn't specify

the type then you go ahead encoded as

type two and you will use

z79.4 long-term use of insulin remember

the default is type

two and also want to just tell you if

patient is treated with both oral

medications and Insulin so both oral

medications oral hypoglycemics and

Insulin you will cod

the insulin and the oral hypoglycemics

code them

both and do not code insulin as

long-term use don't use as long-term use

insulin code if the treatment is

temporary if you see that term temporary

we're not coding insulin as long-term

use now guideline

[Music]

c5g let me see is this right well I

guess it is C15 Point G is another one

too but for now C15 Point G this is

chapter 15 right so when a patient is

pregnant and they have