Diabetes Practice Liaison Program (DPL)

Coding Diabetes MellitusCoding Diabetes Mellitus

Introduction

· Diabetes mellitus is a very dangerous

disease that affects as many as 16

million Americans. It is one of the

leading causes of death by disease.

· There are four types: Type 1, Type 2,

Gestational, and Other.

Diabetes Mellitus

· Type 1 Diabetes:

· Insulin-dependent diabetes (IDDM)

· Juvenile diabetes

· Can occur at any age

· Occurs suddenly

Diabetes Mellitus

· Type 2 Diabetes:

· Non-insulin-dependent diabetes (NIDDM)

· Can occur at any age but most often in adults

over the age of 40

· Occurs gradually

Diabetes Mellitus

· Gestational Diabetes Mellitus (GDM):

· Usually a temporary condition occurring

during pregnancy

· Can increase risk of developing diabetes later

Hyper/Hypoglycemia

· Hyperglycemia: Abnormally

high glucose levels

· Hypoglycemia: Abnormally low

glucose levels

Coding Diabetes

· Once a patient has been diagnosed

with diabetes mellitus: · All codes require FIVE digits: 250.xx

· Almost always reported because diabetes

is a systemic disease

Coding Diabetes

Diabetes with manifestations will

always require at least TWO codes:

· First, the diabetes code: 250.xx

· Second, the manifestation code

Coding Diabetes

Diabetes Mellitus: Code category 250

· Fourth Digit (250.xx) will identify

the manifestation, if any.· For example:

· 250.0x No manifestation

· 250.4x Renal manifestation

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Coding Diabetes

Fifth Digit (250.xx) will identify

the current status of the diabetes.· The specific type of diabetes: Type 1 or

type 2

· Does the documentation specifically

state uncontrolled?

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Coding Sequence

· Diabetes Code (250.xx): Always

listed before any manifestation code

· If not the reason for the encounter, list

the diabetes code after the codes for

the reason.

Insulin Use

· When a patient with type 2 diabetes

uses regular insulin, code also:

· + V58.67 Long-term (current) use

of insulin

· Do not use this code with an individual

diagnosed with type 1 diabetes.

Insulin Pumps

· Underdose due to malfunction of pump

OR

· Overdose due to malfunction of pump

· Add code:

996.57 Mechanical complication of

other specified prosthetic device,

implant, and graft, due to insulin

pump

Diabetes Insipidus

· Diabetes Insipidus: Disorder of

water metabolism; also known as

pituitary diabetes insipidus