question: DM/Renal/HTN combination

cheryl.teigman@ehcny.orgcheryl.teigman@ehcny.org
in Home Care Coding General
The MD has documented in the progress notes that the patient has CKD due to Diabetes (E11.22). The patient also has HTN. I am confused on how to code as HTN has an assumed causal relationship with CKD and is always coded together (I12.9/N18.9) unless the MD states otherwise. As the CKD is stated as being caused by the DM, do I code the HTN separately (I10) as the causal relationship is stated between DM and CKD; or the 3 together (E11.22/I12.9/N18.9)?

Thanks for any assistance/guidance you can give me.

Comments

  • snorboo12snorboo12
    edited April 2017
    Hi Cheryl......I would code the 3 together.

    Shari
  • cheryl.teigman@ehcny.orgcheryl.teigman@ehcny.org
    edited April 2017
    Even if the primary focus of the care is the DM? Thanks for your help!
  • Unknown
    edited April 2017
    E11.22 should be first if that is the focus of care.


    Brandy Slate, RN, HCS-D, COS-C

    Chief Operating Officer

    Codes Correct

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  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited April 2017
    UUGGHH!!!!

    Nancy Wolverton RN,CCM
    QR Specialist, Central Office
    5800 West 10th St., Suite 300
    Little Rock, AR. 72205
    Ph# 501-280-4913
    Fax# 501-280-4385
    Nancy.Wolverton@arkansas.gov
  • cbrunk@totalhh.comcbrunk@totalhh.com
    edited April 2017
    Depending on what your focus of care is, my understanding is that it could be coded as follows as well:

    E11.22
    I13.0
    I15.XX
    N18.XX

    Priscilla Brunk RN, HCS-D
    Corporate Coder
    Cell: 772-284-1185
    Fax: 954-962-2667
  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited April 2017
    That is my understanding as well. All depends upon the POC focus.

    Nancy Wolverton RN,CCM
    QR Specialist, Central Office
    5800 West 10th St., Suite 300
    Little Rock, AR. 72205
    Ph# 501-280-4913
    Fax# 501-280-4385
    Nancy.Wolverton@arkansas.gov
  • cbrunk@totalhh.comcbrunk@totalhh.com
    edited April 2017
    Thanks for confirming because I was afraid I was doing it wrong. but depending on if the RN is focusing on teaching DM or CHF depends on how I code it



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