Resolved DM neuropathy

[LisaK_42876]

Is there an assumed relationship between DM and neuropathy? the MD didn't state there was, but I was unsure if there is an assumed relationship?

 

[Lori]

In the alphabetic index, unspecified peripheral neuropathy is coded as G62. 9 for polyneuropathy, unspecified. Rationale: An automatic link can be made to code diabetes mellitus with neurological complications if both conditions have been documented as active or current.

Please see this thread https://www.cco.community/threads/casual-relationships.5663/

https://www.arkansastotalcare.com/content/dam/centene/artotalcare/pdfs/508_ARTC20-H-158_Diabetes%20Mellitus%20Coding%20Tip%20Sheet.pdf

Coding Diabetes Mellitus with Associated Conditions

Overseen by AHIMA’s coding experts for the Journal of AHIMA website, the Code Cracker blog takes a look at challenging areas and documentation opportunities for coding and reimbursement. Check in each month for a new discussion.There has been some confusion among coding professionals regarding...

journal.ahima.org

Here’s a list of the associated diabetic conditions where the link is assumed in ICD-10-CM:​

• amyotrophy
• arthropathy NEC
• autonomic (poly) neuropathy
• cataract
• Charcot’s joints
• chronic kidney disease
• circulatory complication NEC
• coma due to hyperosmolarity, hypoglycemia, ketoacidosis
• complication specified NEC
• dermatitis
• foot ulcer
• gangrene
• gastroparalysis
• gastroparesis
• glomerulonephrosis, intracapillary
• glomerulosclerosis, intercapillary
• hyperglycemia
• hyperosmolarity with coma
• hypoglycemia with coma
• ketoacidosis with coma
• kidney complications NEC
• Kimmelsteil-Wilson disease
• loss of protective sensation(LOPS) – see Diabetes, by type, with neuropathy
• mononeuropathy
• myasthenia
• necrobiosis lipoidica
• nephropathy
• neuralgia
• neurologic complication NEC
• neuropathic arthropathy
• neuropathy
• ophthalmic complication NEC
• oral complication NEC
• osteomyelitis
• periodontal disease
• peripheral angiopathy with gangrene
• polyneuropathy
• renal complication NEC
• renal tubular degeneration
• retinopathy with macular edema or resolved following treatment
• retinopathy nonproliferative with macular edema (mild, moderate, or severe)
• retinopathy proliferative with combined traction retinal detachment and rhegmatogenous retinal detachment, macular edema, stable proliferative diabetic retinopathy, traction retinal detachment involving the macula, and traction retinal detachment not involving the macula
• skin complication NEC
• skin ulcer NEC

If the MD documents another etiology for the condition DO NOT code to a diabetic complication or assume the link with diabetes.

If unsure about a specific condition being due to or “with” diabetes, coders can look the condition up in the ICD-10-CM Index. All the above associated diabetic conditions will have an entry for “diabetic.” If you search those terms.

Coding Tip: Coding Diabetes Mellitus with Assumed Conditions

Diabetes continues to be a challenge for coders since the new instruction/guideline was released in 2016.

hiacode.com

A key concept for accurate diabetes coding is that of causal relationships. A causal relationship is a documented link between a disease (etiology) and a condition (manifestation) caused by that disease. For a coder to report a causal relationship between diabetes and a complication of diabetes, the provider must establish an unambiguous link in the documentation.

Identify Causal Relationship Links in Diabetes

Small differences in documentation language play an important role in diagnostic coding. A key concept for accurate diabetes coding is that of causal

www.aapc.com