Frequently Asked Questions
If you have coding questions regarding Medicare Risk Adjustment, HCC codes or general coding and documentation questions please ask a coder at Susan.Wyatt@caremore.com. They will be answered in the order received and then posted in the FAQ.
Questions:
Q. If a patient has multiple complications due to diabetes; do I have to code all of the 250.XX codes for each complication? Example, patient has Peripheral Neuropathy and CKD both due to diabetes, can I just code 250.40 for diabetes with renal manifestations.
A. No, you must code all of the appropriate 250.XX codes. If a patient has Peripheral Neuropathy due to diabetes the codes would be 250.60 Diabetes with Neurological Manifestations and 357.2 for the Peripheral Neuropathy in Diabetes. For the CKD due to Diabetes you would code 250.40 Diabetes with Renal Manifestations and 585.9 for the unspecified CKD. The diagnosis of Peripheral Neuropathy due to Diabetes and CKD due to Diabetes would require 4 ICD-9 codes.
Q. I am a podiatrist and if I document Neuropathy and Diabetes, would that be coded 250.60 and 357.2?
A. No, you cannot assign 250.60 when there isn’t any cause and effect relationship stated. Also you cannot assign 357.2, Polyneuropathy in Diabetes, when documented as Neuropathy. The ICD-9 indexes the term “Neuropathy” as 355.9. The physician specialty or provider type does not influence coding, since a coder cannot infer anything even though a podiatrist most likely means Polyneuropathy or Peripheral Neuropathy.
Q. What is the code for CAD?
A. CAD would be coded 414.01 if there is documentation of a CABG as well. If there isn’t any documentation of the patient having a CABG then 414.00 would be the correct code.
When documenting CAD if the patient has Angina or Unstable Angina or has had an Old MI you would want to document and code that as well.
Q. How do I code a CVA with weakness?
A. The code for CVA with weakness would be 438.89. If however your patient has CVA with R or L sided weakness and you document it as such the code is 438.20.
