Icd-9 Codes

sunnygirl272 · Feb 18, 2003

from yahoo health...

people with diabetes have high blood glucose. this is because their pancreas does not make enough insulin or their muscle, fat, and liver cells do not respond to insulin normally, or both.
there are three major types of diabetes:
type 1 diabetes is usually diagnosed in childhood. the body makes little or no insulin, and daily injections of insulin are required to sustain life. without proper daily management, medical emergencies can arise. iddm
type 2 diabetes is far more common than type 1 and makes up about 90% of all cases of diabetes. it usually occurs in adulthood. here, the pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. many people with type 2 diabetes do not know they have it, although it is a serious condition. type 2 diabetes is becoming more common due to the growing number of older americans, increasing obesity levels, and widespread failure to exercise. niddm
gestational diabetes is high blood glucose that develops at any time during pregnancy in a person who does not have diabetes

sunnygirl272 · Feb 18, 2003

NOw...tell us what you think the answers to your questions are, and we will help guide you along....somewhat.....but try doing a search on your own to refresh your diabetic knowledge also...

kids · Feb 18, 2003

People! She is not just asking for help figuring out DM...she's asking for specific help with coding. I am actually an Certified Medical Claims Ananlyst...which is a fancy way of saying I spent a year in school learning how to do ICD and CPT coding...it is not as simple as it seems, the manual does not always use the same terminology that we are used to and using the wrong code can seriously effect reimbursement.

Jenny:

your codes are missing the 4th digits:

250 Diabetes mellitus

250.0 Diabetes mellitus without mention of complication

250.1 Diabetes with ketoacidosis

250.2 Diabetes with hyperosmolar coma

250.3 Diabetes with other coma

250.4 Diabetes with renal manifestations

250.5 Diabetes with ophthalmic manifestations

250.6 Diabetes with neurological manifestations

250.7 Diabetes with peripheral circulatory disorders

250.8 Diabetes with other specified manifestations

250.9 Diabetes with unspecified complication

source: http://www.cs.umu.se/~medinfo/ICD9/icd9cm_group3.html#250

you still have to have the 5th digit and that is where insulin is factored in...for coding purposes DM is either IDDM or NIDDM regardless of age of onset:

(0) NIDDM not stated as uncontrolled

(1) IDDM not stated as uncontrolled

(2) NIDDM uncontrolled (I believe this is the code used for NIDDM who end up on insulin)

(3) IDDM uncontrolled

I would suggest you register at the link below...for free you can get many common ICD-9 codes (costs money for the ICD-10 codes).

http://www.eicd.com/Default.htm

I would suggest that you READ the section in the ICD-9 manual...pay close attention to words like specified and stated.

Keep in mind that as no one can assign a medical dx except the Doc...however we can read read thru the notes and pick out info that rephrases the dx.

If you need anymore help feel free to PM me.

renerian, BSN, RN · Feb 18, 2003

Yep you need the fifth digit........in your manual it will say use a fifth digit........I have my book right here at home.

I hope you have the 2003 version as there were many changes.

See where you look down the list and it lists the 4 digits with a darkened area for the fifth digit-that list of 0,1,2,3 goes as the 5th digit. Do any of the listed descriptors fit?

renerian

sunnygirl272 · Feb 18, 2003

Originally posted by kids-r-fun
People! She is not just asking for help figuring out DM...she's asking for specific help with coding. I am actually an Certified Medical Claims Ananlyst...which is a fancy way of saying I spent a year in school learning how to do ICD and CPT coding...it is not as simple as it seems, the manual does not always use the same terminology that we are used to and using the wrong code can seriously effect reimbursement.

wtf...Ummm..people....she also asked for help with diabetes....as far as which is which.......sooo...stupid me helped her with part of it,.,,i shoulda left the fargin' thread alone...

((bowing down to the greatness of the Certified Medical Claims Ananlyst))

JennyHHRN · Feb 18, 2003

WHOA! YOU GALS DON'T NEED TO FIGHT OVER ME!!!

Kids-r-fun: thank you soooo much, you interpreted my message and answered it on the nose!!

Sunnygirl272: thanks for the diabetes factoids, i can use it to educate others around my office who don't realize the intricate differences in the diagnosis of diabetes.

renerian: thanks for the backing up Kids-r-fun, it always helps to have another person in agreement!!!

ps. Renerian and Kids-r-fun: i'm so glad to have found you both!! I have been pulling my hair out trying to explain to the higher ups that we need to rehire a trained coding expert!!! I soo appreciated what you do since they turfed this job to me temporarily. I hope it's okay to consult with you both from time to time.....thanks again....

renerian, BSN, RN · Feb 18, 2003

It is a learned skill that is for sure. I have to code every day and have been doing it for 11 years.

Glad I could help..................sometimes it is hard to get the right response the first time LOL.

renerian

kids · Feb 18, 2003

You are welcome, I'm glad I could help...coding can be a challenge.

Oh, and excuse me for mis-spelling analyst, I don't think it warrented the reaction it got but I'm not going to play the game even if my feelings are hurt.

Like I said Jenny, feel free to PM me if you need any more help.

sunnygirl272 · Feb 19, 2003

Originally posted by kids-r-fun
...Oh, and excuse me for mis-spelling analyst, I don't think it warrented the reaction it got but I'm not going to play the game even if my feelings are hurt...

thought about making this a pm, but felt the need to defend myself in public...

1) re spelling: honestly did not even notice your misspelling until YOU pointed it out...i had only copy&pasted rather than type your whole title out...

2) normally, you're cool in my book, kids...but you jumped all over my posts and got my dander up....the OP had implied she needed a refresher on DM also...which i attempted to assist with...also wanted to hear her try to figure out her questions herself, also, hence the 2nd post i made...next thing i know you've romped all over me for my post...:

Originally posted by kids-r-fun
People! She is not just asking for help figuring out DM...she's asking for specific help with coding.

that's all i have to say here in public. Jenny...my apologies to you for the catty turn of this thread....

Melinda

Home Health Columnist / Guide · Feb 19, 2003

Kids R Fun has posted great website. I've used it before. If you do not have a coding book in your office you should get one; if you have a book look at the introduction pages---explains how to code to higest degree of specificity.

This website also has easily understood introduction to coding:

OFFICIAL ICD-9-CM GUIDELINES FOR CODING AND REPORTING

http://www.eicd.com/Guidelines/Default.htm

In addiiton to coding for diabetes as above, when coding leg ulcers along with diabetes---if the leg ulcers are a result of diabetes you should code using 250.8X (plus 5th digit) ---or if due to diabetic neuropathy 250.7X. This will result in higher reimbursement and bring in an additional $2,000 to agency!

Know that codes are updated each October so need to check for latest codes:

2002 Updates to the ICD-9-CM Diagnosis Codes

Effective October 1, 2002

http://cms.hhs.gov/medlearn/icd9code.asp

Taking a Closer Look at 2003 ICD-9-CM, DRG Changes

http://library.ahima.org/xpedio/groups/public/documents/ahima/pub_bok1_016283.html

See if local hospital or community college offers coding course---cost would be ofset by improved reimbursement to your agency.

E Codes NOT used in homecare---rarely 800-999 codes (Injury and Poisioning).

Cancer DX are listed under Neoplasms---if unknown if tumor cancerous, use second column code.

Can also find codes commonly under: Complications, symptoms and deficiency.

Good luck---let us know if we can help.

renerian, BSN, RN · Feb 19, 2003

Nice post karen. Very helpful.

renerian