tci ED Coding & Reimbursement Alert - 2010 Issue 3

Reader Questions : Remember Primary Dx Code for These Diabetics

Question: I have a puzzling claim in front of me. The notes indicate that the nonphysician practitioner (NPP) provided a level-three E/M service for a patient with "2ndary diabetes w/renal manifest." Do I have enough information to choose a diagnosis code with these notes?Minnesota SubscriberAnswer: You've got enough there to choose 249.40 (Secondary diabetes mellitus with renal manifestations, not stated as uncontrolled, or unspecified) for the patient's secondary diabetes.The 249.40 code reveals two elements: the patient has diabetes, and the diabetes is causing additional physiological issues (in your patient's case, renal manifestations). You need...

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