Chapter IV - Endocrine, nutritional and metabolic diseases Flashcards
Name the 2 main types of diabetes and the differences between them.
Type 1 diabetes mellitus (T1DM)
* A severe form
* Usually an abrupt onset before age 25
* Usually difficult to control
* Insulin deficient - ketoacidosis occurs frequently
* Daily injections of insulin
* AKA Type I, Juvenile type, IDDM, T1DM
Type 2 diabetes mellitus (T2DM)
* Mild often asymptomatic
* Onset usually after the age of 40
* Frequent in overweight persons
* Can be treated by diet or oral hypoglycaemics
* Also known as Type II, Adult maturity onset, NIDDM, T2DM
What do the fourth character subdivisions for use with categories E10-E14 Diabetes mellitus describe?
Manifestations and complications of diabetes.
How is diabetes with multiple associated complications coded?
Each complication must be coded.
Which 2 types of diabetes are excluded from Chapter IV?
Diabetes in pregnancy, childbirth and the puerperium (O24.-)
Diabetes in neonate (P70.2)
If a patient has multiple complications classified to a dagger asterisk combo, how must these be coded?
A dagger asterisk combo must be assigned for each complication.
This applies even when the 4th character diabetes code is the same
(eg. E10.2D, H28.0A, E10.2D, H36.0A)
If a patient has multiple complications that are not classified to a dagger asterisk combo (ie.E10-E14 + .0, .1, .5 or .6), how must these be coded?
Each complication must be coded following a code from category E10-E14.
If the 4th character is the same from E10-E14 for all complications, one diabetes code must be used followed by all the codes for the complications listed after.
How should Myocardial infarction, cardiac failure or angina due to diabetes be coded?
The diabetes must be recorded in a secondary position with a 4th character of .6 With other specified complications
This is an exception to DCS.IV.1 Diabetes Mellitus - usually the complications would be listed after the diabetes code.
How should hyperglycaemia in diabetic patients/uncontrolled diabetes and out of control diabetes be coded?
with the 4th character subdivision .9 Without complications as these are not considered complications of diabetes.
What is another acronym for HHS Hyperglycaemic hyperosmolar state?
HONK
Hyperosmolar nonketotic state
When can codes from category E66.- Obesity be assigned?
Only when a diagnosis of obesity is recorded in the medical record.
If only BMI is recorded in the medical record, this should not be used to assign a code from E66.-.
When can E78.0 Pure hypercholesterolaemia be assigned?
Only when a diagnosis of high cholesterol is confirmed to be a definitive diagnosis of hypercholesterolaemia by the responsible consultant and is not just an abnormal test result.
How must manifestations of cystic fibrosis be coded?
an additional code identifying the manifestations must be assigned immediately after a code from E84.- Cystic fibrosis (where doing so adds further information about specific manifestations).
If there are multiple manifestations of cystic fibrosis how should these be coded?
Multiple codes from E84.- must be used where multiple manifestations are present.
When should dehydration be coded?
Must always be coded if documented as severe or where it has been treated with intravenous fluids.
When should hypovolaemia be coded?
Must always be coded when it has been treated with intravenous fluids or blood transfusion.
