Endocrine Flashcards
Diabetes?
ALWAYS CODE!
- E11 type 1
- E12 type 2
- E13 - other
- E14 - Unspecified
Initial DX of SDM
Assign E13 code
+ Y42.0 glucocorticoids causing adverse effects
ONLY TYPE OF DIABETES ALLOWABLE AS DX TYPE 2
Hypoinsulinism due to pancreatectomy during episode of care where pancreatectomy took place
- E89.1 postprocedural hypoinsulinism
- Y83.6 removal of organ (partial, total, etc.)
Hypoinsulinism due to pancreatectomy NOT during episode of care where pancreatectomy took place
Appropriate E13 code
DM with poor control
- E1^.64 inadequate control
- mandatory assignment on admission or during episode of care
- never type 2 or 3
- never assign to newly dxed diabetics
Insulin initiated for DM II during episode of care
-E11.64
Diabetic coma/ketoacidosis
- Never assign inadequately controlled as it is already implied
Requires two codes:
Additional code to identify type of DM coma
Three types:
- hypoglycemic
- ketoacidosis
- hyperosmolar
- - hyperosmolar coma can occur in DM for reasons other than poor control. Do not assign diabetic coma in this case.
Diabetic complications
- Cause and effect need not be established, to code as diabetic complication
Microvascular:
- kidneys, eyes, nervous system, skin, mucus membranes, musculoskeletal
Macrovascular:
- heart disease, stroke, PVD
Multiple complications at least one meets clin. Sig.
Code each clinically significant complication separately!
Multiple complications none meet clin. Sig.
Use -E1^.78 multiple complications
Hypoglycemia
- E1^.63
Code when documented with dm
Can be dx type 2
Lactic Acidosis as adverse reaction to metformin (glucophage)
-E1^. 11
+Y42.3 adverse effects insulin….
DM w/o mention of complication
Can only be on same abstract as:
- E1^.1^
- E1^.63 hypoglycemia
Dialysis
Must capture CCI code
DM - ophthalmic complications
If retinopathy:
-H36.0*
- - with dagger code ahead
If senile or age related:
- E1^.38
If other type of cataracts:
- E1^.9
DM - neurological complications
Somatic:
-peripheral
-cranial
-mononeuropathy - 1 nerve specified
- - G59.0*
Else
-polyneuropathy
- - G63.2*
Autonomic:
- nerves that control bodily function
DM - angiopathy
E1^.5^ sequencing and dx typing rules for other complications do not apply, use standard dx typing rules and documentation to sequence and dx type.
Circulatory complications in DM = Macrovascular
Borderline diabetes
Don’t exist, seek clarification in documentation.
May refer to mild DM, diet controlled DM, or glucose tolerance R73.0
Obesity
Not mandatory for capture
- can be mrdx if admit for stomach reduction/gastric banding
Dehydration
Only coded when condition in own right or when requires IV solution
Thyroid crisis or storm
Assign code that describes any present type of thyrotoxicosis as well
- requires additional code for graves’ disease or hypothyroidism
Neck dissection
Selective
- excision partial lymph node(s) cervical
Functional
- excision total lymph node(s) cervical
Modified Radical
- excision radical lymph node(s) cervical, modified radical neck dissection
Radical
- excision radical lymph node(s) cervical, radical neck dissection
Extended Radical
- excision radical lymph node(s) cervical, extended Radical neck dissection
