ICD10 Coding and Diabetes
Welcome to CMS eHealth. By October 1, 2015, the new ICDcoding system will be in place for both diagnosesand inpatient procedures. Using ICD10, s willcapture much more information, meaning they can betterunderstand important details about a patient's healththan with ICD9. The new codes reflecthow health care has changed over the past 30 years with manyadvances in al practice.
You'll notice updates,including definition changes, terminology changes,and a lot more specifics. The most obvious change is thatthe code structure has expanded. While the old codes havethree to five characters, the new codes have up to seven, allowing for more detaileddescriptions. The first three charactersrepresent the category of disease or health condition,followed by a decimal point.
The fourth, fifth,and sixth characters represent al details,such as the cause of the disease, its severity,and its anatomical location. Let's look at how this all worksusing the example of diabetes. ICD9 has two major categoriesof diabetes codes, diabetes and secondary diabetes, but ICD10 separates Type 1diabetes from Type 2 diabetes. ICD10 also eliminates the broadcategory of secondary diabetes,
instead offeringsecondary options, such as underlyingconditions or causes. To capture more details,subcategories can be added to represent both complicationsand affected body systems. For example, the diabetessubcategories include ketoacidosis,kidney complications, ophthalmic complications,neurological complications, and circulatory complications.
Let's say a patient has diabetesdue to an underlying condition. That's code E08,followed by a decimal point. Next come the detailsin the form of subcategories, starting with the fourth digit. Ketoacidosis, for example,has a fourth digit of 1. To add even more detail,a fifth digit of zero is ketoacidosis without coma, and a fifth digit of oneis ketoacidosis with coma.
These subcategoriesstay the same, no matter what type of diabetesis being described. For example, diagnosis code .621 describes the complicationof foot ulcer. So E10.621 is type 1 diabeteswith foot ulcer, and E11.621 is type 2 diabeteswith foot ulcer. In this example,the provider has documented the category of diabetesand the complications.