Medical Billing Forum

Coding => Coding => Topic started by: Nadine on November 22, 2011, 11:41:26 AM

Title: HTN/CKD/DM combo codes
Post by: Nadine on November 22, 2011, 11:41:26 AM
When a patient presents for HTN/CKD, coding guidelines state to code to 403.9X and 585.X, with ďXí coding to the severity of CKD. Then letís say the patient has DM II. When can you and canít you code to the DM renal manifestation code, 250.4X? Iím told the connection has to be made first in order to code this. Another thought, CKD is usually associated or a cause of DM. The coders desk reference states, once the conection is made, this follows the patient on subsequent visits regardless of the documentation.

Any experience with this code would be helpful. I think I'm just getting myself confused. As a biller, I have sent these back to coding for correction but I get these returned to me stating the documentation is not linking the conditions. So I say, query the provider, is this warrented?