CODING & DOCUMENTATION

 

Fam Pract Manag. 2018 May-June;25(3):33.

Author disclosure: no relevant financial affiliations disclosed.

ICD-10 CODING FOR HYPERTENSION AND DIABETES

Q

Which ICD-10 codes should I report for a patient who has both hypertension and Type 2 diabetes?

A

Report code I10 for hypertension and the appropriate E11.-code for Type 2 diabetes with any documented manifestations. If a causal relationship exists between the two conditions, they still must be coded separately because ICD-10 does not presume a linkage between hypertension and diabetes as it does with some other conditions. To report hypertension as a complication of diabetes, submit I15.2, “Hypertension secondary to endocrine disorders” and E11.-for diabetes, and include a statement in the physician's note indicating the diabetes is the cause of the hypertension.

PHYSICIAN CERTIFICATION OF DIABETIC SHOES

Q

What documentation does Medicare require when I am asked to certify the need for diabetic shoes or inserts that a podiatrist ordered for my patient?

A

Medicare requires that the physician who is comprehensively treating the patient's diabetes must certify his or her eligibility for diabetic shoes or inserts. The patient must have one or more of the following conditions in one or both feet:

  • Previous partial or complete foot amputation,

  • History of foot ulceration,

  • History of preulcerative calluses,

  • Peripheral neuropathy with evidence of callus formation,

  • Foot deformity,

  • Poor circulation.

If another provider conducts the foot exam and documents at least one of the qualifying foot conditions at an in-person visit within six months of the anticipated delivery of the shoes or inserts, the certifying physician must do the following:

  • Obtain a copy of the other provider's medical record,

  • Initial, date, and indicate agreement with it as appropriate,

  • Sign the certification statement within three months prior to delivery of the shoes or inserts.

Suppliers of diabetic footwear must be able to provide the certifying physician's do

ABOUT THE AUTHOR

Cindy Hughes is an independent consulting editor based in El Dorado, Kan., and a contributing editor to FPM.

Author disclosure: no relevant financial affiliations disclosed.

WE WANT TO HEAR FROM YOU

Send questions and comments to fpmedit@aafp.org, or add your comments below. While this department attempts to provide accurate information, some payers may not accept the advice given. Refer to the current CPT and ICD-10 coding manuals and payer policies.

 
 

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