Diabetes Management: Follow These Simple Steps to Ace Diabetes Coding

ICD9 Codes

Tip: Concentrate on diabetic complications related to existing episode of care.

Selecting the accurate diabetes diagnosis can seem quite complex, thanks to factors like your family physician seeing patients with more complicated cases than in the past and their treating diabetic manifestations. Use these expert medical billing and coding steps for perfect diabetes diagnosis coding to make certain that your ICD-9 codes validate the services you bill.

1. Select the Fourth Digit First

You'll start code selection with diagnosis family 250.xx (Diabetes mellitus). Decide the fourth digit in line with the type of diabetic complication the patient has, if any.

Example: A patient comes with diabetic hypoglycemia. You must report 250.8 (Diabetes with other specified manifestations) as your first four digits. In case, on the other hand, the patient presents with diabetes devoid of any complications, your first four digits will essentially be ICD-9 code 250.0 (Diabetes mellitus without mention of complication).

Medical Billing and Coding Tip: Diabetes patients might have more than one complication. If this is the case, you must code only the complication most applicable to services the physician renders that day.

2. Ascertain the Type for Fifth Digit

The fifth digit of the diagnosis ICD-9 codes OF Supercoder.com delivers the final two pieces of information on the patient's diabetic situation: the diabetes type (I or II) and whether or not it is controlled.

To choose the proper fifth digit, you should first know what the following listed ICD-9 descriptor terms mean:

• Type I – (The patient's pancreatic beta cells no longer produce insulin. People with type I diabetes must take insulin. ICD-9 descriptors also refer to type I as "juvenile type" diabetes)
• Type II (The patient's beta cells do not produce sufficient insulin, or the beta cells have developed insulin resistance. People with type II may not have to take insulin)
• Not stated as uncontrolled (The patient's diabetes is managed sufficiently by diet and/or insulin)
• Uncontrolled (A patient can have uncontrolled diabetes when the physician documents that blood sugar levels are not acceptably stable under the current treatment regimen, when the patient is not in compliance with his diabetes management plan, or if the patient is taking medications for another illness that interfere with diabetes management)

Medical Billing and Coding Tip: First, you must check the physician's documentation to see what sort of diabetes the patient has and whether the condition is controlled. Then select one of the following fifth digits:

• 0 (Type II or unspecified type, not stated as uncontrolled)
• 1 (Type I (juvenile type), not stated as uncontrolled)
• 2 (Type II or unspecified type, uncontrolled)
• 3 (Type I (juvenile type), uncontrolled)