Posted on Friday, August 18, 2017 1:05 PM
Many coders have mentioned seeing physicians documenting HTN due to diabetes and this has caused a bit of concern. The difference is, HTN due to diabetes is secondary HTN and secondary HTN is not assumable to CHF or CKD, like essential HTN. For this reason, your sequencing should be different when coding these diseases. According to Mary Deakle, BCHH-C, COS-C, Manager of Compliance and Education with Corridor, “a patient with hypertension due to diabetes, CKD stage IV and CHF should be coded: E11.59 (Diabetes with circulatory manifestations), I15.2 (HTN secondary to endocrine disorders), E11.22 (Type 2 diabetes with chronic kidney disease), N18.4 (CKD, stage 4) and I50.9 (Unspecified heart failure). This sequencing is correct when HTN is the focus of care.”
This sequencing only applies when HTN is stated as related to or caused by the diabetes. If no etiology is stated for these conditions then assume these relationships as per ICD-10 coding guidance.
Feel free to reach out to Corridor for all your coding needs.
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