This page addresses follow-up questions and additional information pertinent to our webinar
Digging into Diabetes.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: When the doctor writes type 1.5 diabetes treated as type 2, I’m told to code as type 2, just wanted to verify.
A: Per Coding Clinic, Third Quarter, 2018: Page 4, type 1.5 diabetes mellitus is assigned to category E13, Other specified diabetes mellitus. It is incorrect to code it as type 2 diabetes mellitus.
Q: How do you code for gestational diabetes controlled by injectable non-insulin medications? The codes allow for reporting of GDM controlled by diet, insulin, or oral hypoglycemic drugs, but the guidelines don’t address injectable non-insulin medication.
A: Haugen Consulting Group referenced clinical experts in obstetrical medicine and they stated that injectable non-insulin diabetic medications are contraindicated in pregnancy. It is highly unlikely that this type of diabetic control would be necessary in a pregnant patient.
Q: How is type 1.5 diabetes coded when the provider documents that it is being treated as type 1 diabetes? The patient was on placed on long term insulin.
A: Assign a code from category E13 for other specified diabetes mellitus with code Z79.4, Long term (current) use of insulin. If the type of diabetes is documented as type 1.5, it should be coded as other specified diabetes, regardless of how it is being treated. Instructional notes for category E13 instruct to use an additional code to specify the type of control, including long term use of insulin. Coding Clinic, 2ns Quarter 2024, page 26 indicates that a newly prescribed medication intended for long term use is assigned a code from category Z79.
Q: Should code Z79.4, Long term (current) use of insulin, be assigned with codes in category E10 for type 1 diabetes?
A: No. Patients with type 1 diabetes mellitus require insulin to sustain life. Adding code Z79.4 does not provide any additional information about the patient’s condition. Tabular List notes give instruction to add codes from category Z79 to specify the type of control for every diabetes code category except for E10.
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Senior Consultant
Kristi has served the Colorado Health Information Management Association (CHIMA) as board Director, co-chair of the Data Quality Committee, and co-chair for the ICD-10 Task Force. She is also a past president of the Northern Colorado Health Information Management Association (NCHIMA). Kristi is the proud recipient of the 2011 AHIMA Triumph Award for Mentoring for her voluntary work as the “Coder Coach.” She has also received awards from CHIMA for Distinguished Member (2018) and Outstanding Volunteer (2013) and from AHIMA for Roundtable Achievement in Coding Excellence (RACE).
I enjoyed the overview.