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ICD-10 simplifies coding of diabetic renal, ophthalmic & neurologic manifestations

Just one combination code, E11.311 (Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema), will sufficiently capture diabetic macular edema in ICD-10, whereas, in ICD-9, the condition requires three separate codes: 250.50 for the diabetes, 362.01 for background diabetic retinopathy and 362.07 for the diabetic macular edema.

ICD-10 will simplify the coding of renal, ophthalmic and neurological diabetic manifestations, as most of these conditions, which require a minimum of two codes in ICD-9, are captured with single combination codes in the new code set. In fact, most of the time, the only additional code required when coding diabetic manifestations is that for insulin use (Z79.4, Long term (current) use of insulin) in patients with the type 2 form of the disease [I.C.4.a.3].

The ICD-10 codes that cover diabetes are found in Chapter 4 (Endocrine, nutritional and metabolic diseases) and range from the E08 (Diabetes mellitus due to underlying condition) to the E13 (Other specified diabetes mellitus) categories, depending on the type of the condition (1 or 2) and its cause (such as drug of chemical-induced diabetes, or diabetes resulting from another disease).

Home health coding will make the most use of codes from the E11.- category (Type 2 diabetes mellitus), says Vonnie Blevins, HCS-D, coding and billing manager for Excellence Healthcare in Houston. Just like in ICD-9, when the type of diabetes is not specified, type 2 should be coded [I.C.4.a.2].

Renal, ophthalmic and neurological manifestations are indicated in ICD-10 with the use of the fourth character – ‘2’ for renal, ‘3’ for ophthalmic and ‘4’ for neurological.

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