Dm type 1 and Charcots foot

danielle.stevens@essentiahealth.org · August 2016

My patient has DM type 1 and has a diagnosis of left Charcot's foot, I know I cannot assume this relationship but the only code I come to is A52.16 which the coding tip states only to use this code if Charcot's is caused by syphilis. Can someone please help me in the worst case scenario if no response to my query?

Thanks!

Danie Stevens
Home Health Coder, RHIT
Essentia Health St. Mary's
114 Frazee Street East Detroit Lakes, MN 56501
218-314-7857
Danielle.Stevens@essentiahealth.org

cbrunk@totalhh.com · August 2016

Look at E10.610-DM Type 1 with Diabetic Neuropathic Arthropathy
Coding Tip states do not code Charcot's Joint

Priscilla Brunk RN, HCS-D
Corporate Coder
Cell: 772-284-1185
Fax: 954-962-2667

danielle.stevens@essentiahealth.org · August 2016

So code this instead?

cbrunk@totalhh.com · August 2016

Yes it is a combination code

Priscilla Brunk RN, HCS-D
Corporate Coder
Cell: 772-284-1185
Fax: 954-962-2667

danielle.stevens@essentiahealth.org · August 2016

And wouldn't the MD have to state the relationship of the charcots foot?

danielle.stevens@essentiahealth.org · August 2016

I don't have documentation of the relationship, im wondering what I would use if they have both dx but the MD does not say diabetic charcots.

cbrunk@totalhh.com · August 2016

My understanding of the guidance with regards to the term "with in the index" if patient has DM and Charcots foot you may code as combination code. I may be wrong and hopefully Vonnie will chime in here and help us both, but that was my understanding when they came out with the new/revised guidance regarding DM and manifestations

Priscilla Brunk RN, HCS-D
Corporate Coder
Cell: 772-284-1185
Fax: 954-962-2667

danielle.stevens@essentiahealth.org · August 2016

This is where I get confused with the diabetes! Thank you for your help

danielle.stevens@essentiahealth.org · August 2016

Would this be correct below?

My understanding of the guidance with regards to the term “with in the index” if patient has DM and Charcots foot you may code as combination code. I may be wrong and hopefully Vonnie will chime in here and help us both, but that was my understanding when they came out with the new/revised guidance regarding DM and manifestations

Priscilla Brunk RN, HCS-D
Corporate Coder
Cell: 772-284-1185
Fax: 954-962-2667

cbrunk@totalhh.com · August 2016

Vonnie, another question for you; MD documents “Chronic Pathological Fracture Left Leg” and gives the code M84.40XA wouldn’t I use the pathological fracture of the left leg

Priscilla Brunk RN, HCS-D
Corporate Coder
Cell: 772-284-1185
Fax: 954-962-2667

danielle.stevens@essentiahealth.org · August 2016

Assessment: Ulceration bilateral feet, diabetes type 2 with neuropathy, Charcot foot left.

^^^I don’t think “with” applies here, this is my biggest problem!

danielle.stevens@essentiahealth.org · August 2016

I did forget to ask what code would I use if its not in relation to the DM?

cbrunk@totalhh.com · August 2016

But it does. You would code this one as

DM with ulcer to foot
Code the wounds
DM with Neuropathy
DM with Charcots Arthropathy

Priscilla Brunk RN, HCS-D
Corporate Coder
Cell: 772-284-1185
Fax: 954-962-2667

danielle.stevens@essentiahealth.org · August 2016

So confusing im literally looking for “with”

Thanks ☺

lkpengel · August 2016

“With” does apply here. Charcot’s joints is under the sub-term “with”. The code is E10.610. Ulcer code E10.621.

Dm type 1 and Charcots foot

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