According to the Americans Diabetes Association, approximately 1.25 million American children and adults have Type 1 diabetes. Unlike type 2 diabetes where the body is not able to use insulin the right way, in Type 1 diabetes, the pancreas are unable to produce insulin and regulate blood sugar. Both genetic factors and environmental triggers are involved with the onset of this chronic condition which is characterized by hypoglycemia – dangerously low sugar levels. Symptoms include shakiness, confusion, disorientation and fainting. Medical billing and coding for diabetes is complex due to its associated manifestations.
Knowing how to detect the symptoms of Type 1 diabetes is important to prevent the problem from becoming potentially serious. So the news that dogs can reliably detect dangerously low blood sugar levels in diabetics made headlines. Researchers at Queen’s University in Belfast, Northern Ireland, recently announced that dogs can actually sense hypoglycemia on people’s breath and alert them in time to stop it. According to an ABC news report, a couple of organizations in the United States already train dogs to detect low glucose levels. Researchers are now working to find out the odor that helps dogs do this. Identifying that specific compound could allow it to be used in technologies, such as a breathalyzer, to track blood sugar on the breath of people with diabetes.
Official statistics indicate that in 2012, 29.1 million Americans, or 9.3% of the population, had diabetes and that 1.4 million Americans are diagnosed with diabetes every year. In fact, diabetes is among the most common conditions treated by family care physicians and endocrinologists. To get appropriate reimbursement, physicians need to document and Code for the patient’s diabetes as well as the complications that the condition causes to the highest degree of specificity possible. Most physicians overcome these complexities by relying on professional medical billing and coding services.
The ICD10 code for type 1 diabetes is E10.x and that for Type 2 diabetes mellitus without complications is E11.9. In addition, there are specific diabetes codes that require additional codes in order to give more details about the manifestation, such as diabetes with foot ulcer to identify the site of the ulcer, or diabetes with Chronic Kidney Disease to identify the stage of chronic kidney disease. For example:
Code E10.621 (Type 1 diabetes mellitus with foot ulcer) requires the use of an additional code to identify the site of the ulcer (L97.4-, L97.5-).
When a patient has diabetes and a manifestation of it, both conditions should be coded for the patient (i.e. neuropathy due to diabetes, chronic kidney disease secondary to diabetes). Physician documentation should accompany claims and clearly specify that the patient has diabetes and describe any complications associated with it.
Diabetes and several of its manifestations are associated with Hierarchical Condition Category or HCC coding by the Center for Medicare and Medicaid Services (CMS). ICD-10 identifies approximately 200 ICD-10 codes that indicate diabetes mellitus type I, type II or secondary diabetes mellitus and its manifestations. These 200 codes are categorized in one of the following three HCCs:
- HCC17 – Diabetes with Acute Complications
- HCC18 – Diabetes with Chronic Complications
- HCC19 – Diabetes without Complication
Similarly, for diabetes care, maximum reimbursement can be ensured with the use of appropriate CPT codes for patient education, diabetes prevention, eye exam, and so on. In 2016, a new CPT Category III code 0403T has been added for diabetes prevention. This code should be used when the patient lacks a diabetes diagnosis but remains at high risk for developing type II diabetes.
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