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Diabetes "Buddy" Codes


Diabetes “Buddy” codes

The ICD-9-CM code for diabetes is assigned to category 250 Diabetes Mellitus.  The fourth digit is used to indicate the presence of a manifestations or complications identified due to diabetes. Consider the following in the documentation before assigning a code:
1. Type of diabetes the patient has.

2. Is the diabetes is controlled or uncontrolled?
3. Are there manifestations or complications? If so, what are they?

Coding guidelines require two ICD-9 codes be used when coding diabetes and its manifestation.  If the physician just lists 250.40, then it is an incomplete diagnosis. They would need the second “buddy” code to completely document the patient’s condition.  The linking words of “due to” in the medical record are important as well.

The following codes are used to indicate diabetes with manifestations.  The fifth digit determines the type of diabetes and whether it is uncontrolled or not stated as uncontrolled.

250.4X   Diabetes with renal manifestations

250.5X Diabetes with ophthalmic manifestations

250.6X Diabetes with neurological manifestations

250.7X Diabetes with peripheral circulatory disorders

250.8X Diabetes with other specified manifestations

 An example of Diabetes with renal manifestations would be:

250.40 Diabetes with renal manifestations

AND

585.2 Chronic kidney disease, Stage II (mild)

 If documentation in the medical record is not clear or there is a question as to the manifestation, query the physician.
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#HCC  #RiskAdjustment
 
Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.  The information presented herein is for general informational purposes only.


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Location: Poway, CA, USA

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