Ch. 4 - N Codes | Endocrine, Nutritional, and Metabolic Diseases Flashcards
Diabetes mainly
Two main types of DM
Primary and Secondary
Diabetes type where it developed on its own
Primary diabetes
Diabetes with an underlying cause/etiology
Secondary diabetes
Category codes for primary diabetes and their descriptions
E10 - Type 1 diabetes
E11 - Type 2 diabetes
Category codes for secondary diabetes
E08
E09
E13
Drug-induced DM category code
E09
DM due to underlying condition category code
E08
DM other specified category code
E13
Where does diabetes»_space; insulin lead you to?
Type of diabetes
These descriptors signal that the patient’s condition is DM with hyperglycemia as complication. 3 descriptors.
Out of control
Inadequately controlled
Poorly controlled
This descriptor could either mean the patient either had a hyperglycemic or hypoglycemic complication.
Uncontrolled
These two factors have no bearing on how diabetes is coded
Insulin-dependency and age
Default code if no DM type is documented
E11
These (name 3) are medications used long-term for the management of diabetes
Insulin
Oral hypoglycemic drugs
Injectable non-insulin antidiabetic drugs
Some (3) key terms or clues that signify that the patient is using their medication as long-term management
Daily use
Maintenance
Self-administered
Z code to report insulin use
Z79.4
Z code to report oral hypoglycemic drug use
Z79.84
Z code to report injectable non-insulin drug use
Z79.85
During an encounter, when insulin is given temporarily to bring secondary DM patient’s blood sugar under control, what Z code will be used?
None.
Hierarchy in reporting of long-term medications
?? > ?? > ??
Z79.4 > Z79.84 > Z79.85
This kind of diabetes usually resolves after pregnancy.
Gestational diabetes
Reporting / code stacking for pre-gestational Type 1 diabetes
[1] ?
[2] ?
[3] ?
[4] ?
O-E-Z(drug)-Z(week)
[1] O24.0- code
[2] E10- code
[3] Z79.- LT use of drug/maintenance
[4] Z3A.- gestation week code
If the pregnant patient delivered during encounter:
- What would be the last character of the O code be changed to?
- What code to add for outcome of delivery?
- Childbirth
- Z37.-
At least how many codes needed for pre-gestational diabetes reporting?
Two (O and E)
With gestational diabetes, what would we include as a factor/code to report since they don’t have diabetes before (no diabetes type)?
Management of gestational DM
Three ways gestational DM is managed (in hierarchical format from highest to lowest)
- Controlled in part/total by insulin.
- Controlled by oral hypoglycemic drug and/or diet.
- Controlled by diet.
If gestational DM patient is managing her DM via diet and insulin, how will you code?
Just code insulin.
Category code for weeks of pregnancy
Z3A.—
(– is number of weeks)
For underdosing of insulin due to pump failure, how many codes can we expect and what do they reflect?
Four:
[1] T code for mechanical complication. T85.6-
[2] T code for underdosing of insulin. T38.3X6-
[3] E code, appropriate.
[4] Complications DUE to the underdosing
How many codes can we expect for Type 1 DM and hyperglycemia and what is it called?
One. These are called combination codes.
(E10.65)
How is overdosing due to insulin pump failure code stacked?
[1] ?
[2] ?
[3] ?
[4] ?
[1] T code for mechanical complication. T85.614-
[2] T code for POISONING by insulin and oral hypoglycemic drugs. T38.3X1A
[3] E code, appropriate.
[4] Complications DUE to the poisoning.
Pancreas removal causes diabetes,
- How many codes?
- How to code stack?
Three codes.
[1] E89.1 Postprocedural hypoinsulinemia
[2] E13.- Other specified DM
[3] Z90.41 Acquired absence of pancreas
Coding sequence for secondary diabetes from an adverse effect of drug
[1] E09 - drug-induced DM code
[2] Drug code
Coding sequence for secondary diabetes from poisoning?
[1] Drug code
[2] E09 - drug-induced DM code
A patient ADJUSTING for their insulin dosage says what about the status of their medication?
It’s for maintenance/long-term already.
Them needing to adjust it = self-administered.
This type of primary diabetes clues in that the pancreas is no longer functioning.
Type 1 DM
