Diabetes: Difference between revisions
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'''Diabetes can be coded only as a comorbid code.''' | '''Diabetes can be coded only as a comorbid code.''' | ||
We [[List of Diagnoses we | We [[List of Diagnoses we didn't code in old schema | do not code]] newly diagnosed diabetes melitus | ||
'''Mild'''-If treated with insulin or oral hypoglycemics,we do not code diet only controlled DM. | '''Mild'''-If treated with insulin or oral hypoglycemics,we do not code diet only controlled DM. | ||
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* [[Nonketotic Hyperosmolar State]] | * [[Nonketotic Hyperosmolar State]] | ||
**discussion** just added that here from our task meeting today, maybe Con or Laura can summarize/clean up: | |||
"it’s only available as a comorbidity. This will be rectified when we convert to ICD-10, probably in 2016. However, for now we had a discussion about chronic-type conditions that are first diagnosed in the current hospitalization. This is a complex topic that can vary by the diagnosis. For example, a new dx of cancer is almost certainly pre-existing, even if it was not know prior. While a true new diagnosis of DM almost certainly means it was present before the current hospitalization, the fact is that hyperglycemia alone -- even including insulin use -- in an acutely ill patient does not necessarily mean they have DM. After considerable discussion, it was decided that: (a) if a patient without a prior dx of DM is admitted with DKA or with Nonketotic hyperosmolar coma, that we will code DM as a comorbidity, but (b) in other admissions with hyperglycemia, the data collector will have to use their judgement about whether it really represents DM or not, and to code or not code it as a comorbidity based on that judgement." | "it’s only available as a comorbidity. This will be rectified when we convert to ICD-10, probably in 2016. However, for now we had a discussion about chronic-type conditions that are first diagnosed in the current hospitalization. This is a complex topic that can vary by the diagnosis. For example, a new dx of cancer is almost certainly pre-existing, even if it was not know prior. While a true new diagnosis of DM almost certainly means it was present before the current hospitalization, the fact is that hyperglycemia alone -- even including insulin use -- in an acutely ill patient does not necessarily mean they have DM. After considerable discussion, it was decided that: (a) if a patient without a prior dx of DM is admitted with DKA or with Nonketotic hyperosmolar coma, that we will code DM as a comorbidity, but (b) in other admissions with hyperglycemia, the data collector will have to use their judgement about whether it really represents DM or not, and to code or not code it as a comorbidity based on that judgement." | ||
We don't code new diagnosis as comorbids until the next hospital admission, and there is no diagnosis code for diabetes. New diabetes can be coded as [[Other Endocrine Problems]]. | We don't code new diagnosis as comorbids until the next hospital admission, and there is no diagnosis code for diabetes. New diabetes can be coded as [[Other Endocrine Problems]]. | ||
**discussion** | |||
*I was under the impression that Dr Roberts did want us to code some new diagnosis under comorbs. For example, if a newly admitted pt with no past medical history goes for a CT scan and they find cancer in the bowel and the liver, I was under the impression that we were to put bowel and liver cancer in the comorbid category, as well as the diagnosis category. Is this incorrect? If I am correct then why would we not code diabetes in the comorbs for the above scenario? If I am correct, does this apply to all 'new' diagnoses or just some? | *I was under the impression that Dr Roberts did want us to code some new diagnosis under comorbs. For example, if a newly admitted pt with no past medical history goes for a CT scan and they find cancer in the bowel and the liver, I was under the impression that we were to put bowel and liver cancer in the comorbid category, as well as the diagnosis category. Is this incorrect? If I am correct then why would we not code diabetes in the comorbs for the above scenario? If I am correct, does this apply to all 'new' diagnoses or just some?--- ''User:Jthiessen|Jthiessen'' 08:33, 2014 September 5 (CDT) | ||
** Yes there was a discussion about this and I can't remember details... is there anything in [[Comorbid | ** Yes there was a discussion about this and I can't remember details... is there anything in [[Charlson Comorbid coding (pre ICD10)]] that would shed light? Ttenbergen 13:29, 2014 September 5 (CDT) | ||
***Yes as described at the top of the page at HSC we have been coding it as such for the past 10yr--[[User:PStein|PStein]] 06:53, 2014 October 16 (CDT) | ***Yes as described at the top of the page at HSC we have been coding it as such for the past 10yr--[[User:PStein|PStein]] 06:53, 2014 October 16 (CDT) | ||
Latest revision as of 12:26, 21 January 2021
Legacy Content
This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:DiabetesClick Expand to show legacy content.
| edit dx infobox | |
| Category/Organ System: |
Category: Endocrine (old) |
|
Type: |
|
| Main Diagnosis: | Diabetes |
| Sub Diagnosis: |
|
| Diagnosis Code: | 31400 |
| Comorbid Diagnosis: | Only |
| Charlson Comorbid coding (pre ICD10): | 0 |
| Program: | |
| Status: |
|
Diabetes can be coded only as a comorbid code.
We do not code newly diagnosed diabetes melitus
Mild-If treated with insulin or oral hypoglycemics,we do not code diet only controlled DM.
Moderate-Previous hospitalization for Diabetes(DKA,Hyperosmolar coma)
Severe-Complications of neuropathy,retinopathy, or nephropathies or all.Under neuropathies I include diabetic gastropathies/diabetic foot ulcers/ charcot DM foot
patient newly diagnosed with diabetes
can be coded if one of the following is present:
- discussion** just added that here from our task meeting today, maybe Con or Laura can summarize/clean up:
"it’s only available as a comorbidity. This will be rectified when we convert to ICD-10, probably in 2016. However, for now we had a discussion about chronic-type conditions that are first diagnosed in the current hospitalization. This is a complex topic that can vary by the diagnosis. For example, a new dx of cancer is almost certainly pre-existing, even if it was not know prior. While a true new diagnosis of DM almost certainly means it was present before the current hospitalization, the fact is that hyperglycemia alone -- even including insulin use -- in an acutely ill patient does not necessarily mean they have DM. After considerable discussion, it was decided that: (a) if a patient without a prior dx of DM is admitted with DKA or with Nonketotic hyperosmolar coma, that we will code DM as a comorbidity, but (b) in other admissions with hyperglycemia, the data collector will have to use their judgement about whether it really represents DM or not, and to code or not code it as a comorbidity based on that judgement."
We don't code new diagnosis as comorbids until the next hospital admission, and there is no diagnosis code for diabetes. New diabetes can be coded as Other Endocrine Problems.
- discussion**
- I was under the impression that Dr Roberts did want us to code some new diagnosis under comorbs. For example, if a newly admitted pt with no past medical history goes for a CT scan and they find cancer in the bowel and the liver, I was under the impression that we were to put bowel and liver cancer in the comorbid category, as well as the diagnosis category. Is this incorrect? If I am correct then why would we not code diabetes in the comorbs for the above scenario? If I am correct, does this apply to all 'new' diagnoses or just some?--- User:Jthiessen|Jthiessen 08:33, 2014 September 5 (CDT)
- Yes there was a discussion about this and I can't remember details... is there anything in Charlson Comorbid coding (pre ICD10) that would shed light? Ttenbergen 13:29, 2014 September 5 (CDT)
- Yes as described at the top of the page at HSC we have been coding it as such for the past 10yr--PStein 06:53, 2014 October 16 (CDT)
- Yes there was a discussion about this and I can't remember details... is there anything in Charlson Comorbid coding (pre ICD10) that would shed light? Ttenbergen 13:29, 2014 September 5 (CDT)