ICD 10 CM Chapter Specific Guidelines I. C4

Dr. Lisa L Campbell®
30 Jan 201912:00
EducationalLearning
32 Likes 10 Comments

TLDRThe video script discusses ICD-10-CM guidelines for coding endocrine, nutritional, and metabolic diseases, focusing on Section 1C4 (codes E00-E89). It explains diabetes codes as combination codes that identify the type of diabetes, affected body system, and complications. The script details five categories of diabetes codes, the importance of using the correct code for insulin or oral hypoglycemic use, and complications related to insulin pump malfunction. It also addresses secondary diabetes, sequencing and assigning codes, and specific guidelines for drug-induced diabetes.

Takeaways
  • 📅 The video session covers ICD-10-CM guidelines, focusing on section 1C4 related to endocrine, nutritional, and metabolic diseases, specifically the code range E00 through E89.
  • 📗 Diabetes codes are combination codes, identifying the type of diabetes, the affected body system, and any complications affecting that system.
  • 📝 More than one code may be necessary within a diabetes code family (e.g., E08-E13) to fully capture all complications or manifestations of diabetes.
  • 📈 Categories of diabetes codes include E08 (diabetes due to underlying condition), E09 (drug or chemical-induced diabetes), E10 (type 1 diabetes), E11 (type 2 diabetes, the default type), and E13 (other specified diabetes).
  • 📚 Use the alphabetical index under the term 'diabetes' to navigate the different diabetes code families effectively.
  • ✅ If a patient's type of diabetes is not documented, type 2 diabetes (E11) is considered the default type for coding purposes.
  • 🖥 Z codes (Chapter 21) are used for indicating long-term use of insulin or oral hypoglycemics. Z79 is specifically mentioned for patients on long-term diabetes medications.
  • ⚠️ Temporary insulin use in the hospital for acute conditions (like asthma) does not indicate long-term insulin use or a diabetes diagnosis.
  • 🛠 For insulin pump malfunctions leading to underdosing or overdosing, specific codes are assigned (T85.6 for mechanical complications, followed by codes for the type of diabetes and T38.3X6/T38.3X1 for underdosing or overdosing respectively).
  • 👨‍💻 Secondary diabetes codes (E08, E09, E13) highlight complications from another condition or event, including post-pancreatectomy diabetes, with guidance on sequencing and assigning these codes.
  • ✔️ For drug-induced secondary diabetes, refer to sections 1C19E and 1C20 for coding guidelines on adverse effects and poisoning.
Q & A

  • What are combination codes in the context of diabetes coding?

    -Combination codes for diabetes identify the type of diabetes, the body system affected, and any complications that the patient has that are affecting that particular body system.

  • Why might you need to report more than one code from a diabetes code family?

    -You may need to report more than one code from a diabetes code family to identify all of the complications or manifestations that a patient has as a result of diabetes.

  • What does the diabetes code category E08 represent?

    -The diabetes code category E08 represents diabetes due to an underlying condition, meaning the patient had another condition which then subsequently resulted in them having diabetes.

  • What is the default type of diabetes when the type of diabetes is not specified?

    -Type 2 diabetes, represented by code E11, is considered the default type of diabetes when the type of diabetes is not specified.

  • How are insulin and oral hypoglycemics coded in the context of diabetes?

    -If documentation indicates that the patient uses insulin, a Z code from category Z79 is used. There is also a Z code for long-term use of oral hypoglycemics. The type of medication used (insulin or oral) determines the specific Z code applied.

  • What is the coding procedure for complications due to an insulin pump malfunction?

    -For underdosing of insulin due to pump failure, code TA5.6 for mechanical complications of the device is used first, followed by the specific diabetes type and any other manifestations. For overdosing, T85.6 is used first, followed by a code indicating poisoning due to insulin or oral hypoglycemics.

  • What are secondary diabetes codes, and when are they used?

    -Secondary diabetes codes (categories E08, E09, and E13) identify complications or manifestations associated with diabetes that's caused by another condition or event. They are used when diabetes is a secondary condition to another diagnosis.

  • How should insulin use be coded for patients with secondary diabetes?

    -Patients with secondary diabetes who use insulin or oral medication long-term should be assigned a code from category Z79. If both oral medications and insulin are used, the default coding is for insulin use.

  • What instructions are given for coding post pancreatectomy diabetes?

    -For post pancreatectomy diabetes, a code from category E89.1 is assigned, along with a code from category E13 to indicate the type of diabetes. Additionally, a code Z90.41 is used to illustrate the acquired absence of the pancreas.

  • Where can guidelines be found for coding diabetes due to drugs?

    -Guidelines for coding diabetes due to drugs can be found in sections 1C19 letter E and 1C20 of the ICD-10-CM manual, which provide specific instructions for coding adverse effects and poisonings due to drugs.

Outlines
00:00
📚 ICD-10-CM Guidelines for Endocrine Diseases

This section covers the ICD-10-CM guidelines for endocrine, nutritional, and metabolic diseases, focusing on the code range E00-E89. It emphasizes diabetes as a condition with combination codes that indicate the type, affected body system, and complications. The diabetes codes are categorized into five groups: E08 for diabetes due to underlying conditions, E09 for drug or chemical-induced diabetes, E10 for type 1 diabetes, E11 for type 2 (default when unspecified), and E13 for other specified diabetes. The narrative encourages consulting the alphabetical index for comprehensive coding and explains the significance of documenting the type of diabetes and associated long-term treatments like insulin or oral hypoglycemic agents.

05:03
💉 Coding Diabetes and Insulin Use

This paragraph delves into coding for patients with diabetes, especially focusing on insulin and oral hypoglycemics. It explains the Z79 code category for long-term drug use, noting that type 2 diabetes is assumed when not specified. Temporary insulin use in hospitals doesn't imply long-term use or diabetes diagnosis. Complications due to insulin pump malfunctions are discussed, with codes for underdosing (T85.6 and T38.3x6) and overdosing (T85.6 and T38.3x1). The section concludes with secondary diabetes coding, highlighting insulin's precedence over oral medication in coding and the temporary nature of hospital-administered insulin.

10:03
🏥 Secondary Diabetes Coding Guidelines

The final paragraph addresses coding for secondary diabetes, providing guidance on sequencing and assigning codes, particularly for post pancreatectomy diabetes and diabetes induced by drugs. It recommends using codes E89.1 and E13 for post pancreatectomy cases and Z90.41 to signify the acquired absence of the pancreas. Additionally, it points to specific sections in the ICD-10-CM manual for coding diabetes due to drug effects, underlining the need to apply correct guidelines for coding adverse effects and poisonings related to drug-induced diabetes.

Mindmap
Keywords
💡ICD-10-CM
ICD-10-CM stands for the International Classification of Diseases, 10th Revision, Clinical Modification. It is a coding system used in the United States for documenting diagnoses and procedures for medical records and billing purposes. In the video, ICD-10-CM guidelines are discussed to help understand how to classify and code endocrine, nutritional, and metabolic diseases, including diabetes.
💡Diabetes Codes
Diabetes codes are specific classification codes within the ICD-10-CM system that are used to identify and document different types of diabetes, the body system affected, and any complications. These codes are combination codes that provide detailed information about the patient's condition. The video emphasizes the importance of understanding diabetes codes as they can be divided into categories and may require reporting more than one code to fully capture the patient's condition.
💡Combination Codes
Combination codes in the context of ICD-10-CM are codes that include multiple elements of information, such as the type of diabetes, the affected body system, and any complications. They are used to provide a more comprehensive picture of a patient's condition. The video highlights that these codes are essential for accurately documenting and reporting diabetes-related diagnoses.
💡Insulin
Insulin is a hormone that regulates blood sugar levels in the body. In the context of diabetes, it is a crucial treatment for type 1 diabetes and sometimes used in type 2 diabetes. The video discusses the importance of distinguishing between long-term insulin use and temporary insulin administration, as this affects the appropriate ICD-10-CM codes to be used for documentation.
💡Oral Hypoglycemics
Oral hypoglycemics are medications taken by mouth to lower blood sugar levels, commonly used in the management of type 2 diabetes. The video script discusses the coding implications of long-term use of these medications versus temporary use, and how this relates to the documentation and classification of diabetes in medical records.
💡Z Codes
Z codes in the ICD-10-CM system are used to classify factors influencing health status and contact with health services. In the context of the video, Z codes are discussed in relation to long-term use of substances, such as insulin or oral hypoglycemics, by patients with diabetes. These codes help to identify the patient's ongoing treatment regimen.
💡Complications
In the context of the video, complications refer to the secondary health issues that arise as a result of diabetes. These can affect various body systems and must be accurately documented and coded using the ICD-10-CM system. The video emphasizes the importance of identifying and reporting these complications alongside the primary diabetes diagnosis.
💡Secondary Diabetes
Secondary diabetes is a type of diabetes that is caused by another underlying condition or event, such as pancreatitis or the use of certain medications. The video script explains how to identify and code for secondary diabetes, including the use of specific ICD-10-CM codes that capture the relationship between the secondary condition and the diabetes.
💡Sequencing
Sequencing in the context of medical coding refers to the order in which multiple diagnoses or procedures are listed on a patient's medical record. Proper sequencing is important for accurate billing and understanding the clinical picture. The video provides guidance on how to sequence codes for diabetes and its complications, ensuring that the primary condition and any secondary conditions are correctly represented.
💡Endocrine, Nutritional, and Metabolic Diseases
These are a broad category of diseases that involve the endocrine system, nutrition, and metabolism. In the video, this category is the focus of the ICD-10-CM section 1C4, which includes guidelines for coding diabetes and other related conditions. Understanding these diseases is crucial for accurate documentation and treatment planning.
💡Coding Guidelines
Coding guidelines are the rules and instructions that healthcare professionals follow when assigning codes to diagnoses and procedures. These guidelines ensure consistency and accuracy in medical record documentation and billing. The video provides detailed coding guidelines for diabetes and related conditions, emphasizing the importance of following these rules for correct coding practices.
Highlights

Introduction to ICD-10-CM guidelines focusing on endocrine, nutritional, and metabolic diseases code range E00 through E89.

Explanation of diabetes combination codes, which identify the type of diabetes, affected body system, and complications.

Need for reporting more than one code in a family to capture all diabetes complications or manifestations.

Overview of diabetes code categories: E08 (diabetes due to underlying condition), E09 (drug or chemical induced diabetes), E10 (Type 1 diabetes), E11 (Type 2 diabetes), and E13 (other specified diabetes).

Use of the alphabetical index under the main term of diabetes to identify different code families.

Type 2 diabetes is the default type when the type of diabetes is not specified.

Z codes in chapter 21 for long-term use of insulin or oral hypoglycemics.

Guidance on coding for patients using insulin and oral hypoglycemics long-term.

Temporary insulin use in the hospital does not indicate long-term use or diabetes.

Coding complications due to insulin pump malformation, including underdose and overdose codes.

Secondary diabetes codes and their association with other conditions or events.

Instructions for sequencing codes for secondary diabetes, especially post pancreatectomy diabetes.

Secondary diabetes related to drugs and guidance on coding adverse effects and poisoning.

Importance of category E13 for secondary diabetes situations.

Recommendation to consult specific guidelines for coding diabetes due to drugs.

Transcripts

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Related Tags
Medical CodingDiabetes ClassificationEndocrine DiseasesMetabolic DisordersICD-10-CMHealthcare ComplianceInsulin TherapyCoding ComplicationsDrug-Induced DiabetesSecondary Diabetes