Coding Tip: DM with Assumed Conditions
RHIT, CDIP, CCS, CCS-P
Director of Coding Quality Assurance
AHIMA Approved ICD-10-CM/PCS Trainer
Diabetes continues to be a challenge for coders since the new instruction/guideline was released in AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS, First Quarter 2016. This is effective with March 18, 2016 discharges.
ICD-10-CM does assume the link between diabetes and multiple common conditions. In the past, these were not assumed and only coded as related to diabetes when clearly documented or queried by the coder for further clarification.
In the index of ICD-10-CM you will see several assumed conditions. Please continue to familiarize yourself with these so when you are coding the records you will know they are assumed conditions.
Here’s a list of the associated diabetic conditions where the link is assumed in ICD-10-CM:
- arthropathy NEC
- autonomic (poly) neuropathy
- Charcot’s joints
- chronic kidney disease
- circulatory complications NEC
- foot ulcer
- glomerulonephrosis, intracapillary
- glomerulosclerosis, intercapillary
- kidney complications NEC
- Kimmelsteil-Wilson disease
- loss of protective sensation (LOPS)
- necrobiosis lipoidica
- neurologic complication NEC
- neuropathic arthropathy
- ophthalmic complication NEC
- oral complication NEC
- periodontal disease
- peripheral angiopathy
- renal complications NEC
- renal tubular degeneration
- skin complication NEC
- skin ulcer NEC
If the MD documents another etiology for the condition DO NOT code to a diabetic complication or assume the link with diabetes.
Clarification of link of diabetes and osteomyelitis was published in the 4Q2016 AHA Coding Clinic.
AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS, First Quarter 2016
AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS, Fourth Quarter 2016
ICD-10-CM Official Guidelines for Coding and Reporting FY 2017
The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.