Coding diabetes mellitus in icd-10-cm improved coding for diabetes mellitus complements present medical science what does highest level of education mean

Results of a recent coding and clinical documentation pilot study indicate that the ICD-10-CM coding classification changes made for diabetes mellitus have significantly improved coding for this disease. The results of the study noted that although a few ICD-10-CM "unspecified" diabetes codes were assigned, the majority of the diabetes codes sufficiently captured the diagnoses as expressed in the clinical documentation.

In addition, the pilot study noted that the ICD-10-CM diabetes codes complement present medical science-separate type 1 and type 2 diabetes category codes and body system combination codes are a major improvement over ICD-9-CM. Instead of classifying as controlled or uncontrolled, ICD-10-CM classifies inadequately controlled, out of control, and poorly controlled diabetes mellitus by type with hyperglycemia.

This article highlights key ICD-10-CM features for diabetes mellitus coding.

The diabetes mellitus categories E08–E13 are further subdivided into four- or five-character subcategories. When a category has been subdivided into four-, five-, or six-character codes, the diabetes code assigned represents the highest level of specificity within ICD-10-CM. level of income and education ICD-10-CM Tabular Instructional Notes

Diabetes mellitus tabular inclusions notes are introduced by the term "Includes" and appear at the beginning of a category. level of education diploma Categories E10–E13 inclusion notes further define or provide examples of the content within each category, as illustrated in the sidebar.

Similar to ICD-9-CM, "Code first" and "Use additional code" notes are present for some of the diabetes mellitus categories and subcategories that require the underlying condition be sequenced first, followed by the manifestation. The Use additional code note appears at the etiology code and a Code first note at the manifestation code.

ICD-10-CM diabetes codes are combination codes that include the type of diabetes mellitus, body system affected, and the complications affecting that body system. The following examples apply ICD-10-CM chapter 4, "Diabetes mellitus E08-E13," tabular list instructions and illustrate diabetes mellitus code combinations and code specificity.

In ICD-10-CM, diabetes mellitus tabular inclusion notes are introduced by the term "Includes" and appear at the beginning of a category. The "Excludes1" note, meaning "Not coded here," appears under all the diabetes mellitus categories. An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. E13, Other specified diabetes mellitus

There is a combination code for the type 2 diabetes with chronic kidney disease, and the tabular instructs the coder to use an additional code to identify the stage of the chronic kidney disease. level of education meaning At the E11 category level, the Use additional code note instructs the coder to identify insulin use.

Code L97.523 is assigned based on the note under code E11.621 which states to use an additional code to identify site of ulcer (L97.4-L97.5). Code Z79.4 is assigned based on the E11 category level, Use additional code note to identify insulin use.

In addition to chapter 4, accurate ICD-10-CM diabetes mellitus coding requires proficiency in many other chapters as well. level 4 education For example, category E08, Diabetes mellitus due to underlying condition, instructs to code first the underlying condition such as cystic fibrosis, malignant neoplasm, pancreatitis. Category E09, Drug or chemical induced diabetes mellitus, instructs to code first the applicable drug or toxin (T36-T65) for poisonings.

When reporting diabetes in pregnancy, many codes in chapter 15, "Pregnancy, childbirth and the puerperium (O00-O9A)," include a final character indicating the trimester of pregnancy. This character is valuable since poorly controlled diabetes during the second and third trimesters can result in excessively large babies, causing medical risk to both mother and newborn.

In chapter 19, "Injury, poisoning and certain other consequences of external causes (S00-T88)," category T85, Complications of other internal prosthetic devices, implants, and grafts, is used to report diabetic insulin pump complications. Category T85 requires the appropriate seventh character added to each code to describe the encounter type (A: initial encounter, D: subsequent encounter, S: sequela).

Chapters 16, "Certain conditions originating in the perinatal period;" 18, "Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified;" and 21, "Factors influencing health status and contact with health services" also provide codes in relation to diabetes mellitus. Code First and Use Additional Code Examples

Similar to ICD-9-CM, "Code first" and "Use additional code" notes are present for some of the diabetes mellitus categories and subcategories, which require the underlying condition be sequenced first followed by the manifestation. The Use additional code note appears at the etiology code and a Code first note at the manifestation code.