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Thursday, September 10, 2015

If you are a podiatrist, you treat diabetic feet......It's what you do! Know the ICD-10 codes you need to know for treating your diabetic patients.





 Many people getting lost in the trauma coding but unless you are in a very high trauma practice, these should not be your main focus.
Don’t get distracted by the coders who can’t pronounce calcaneusKnow your most common procedures and know how to code them
At risk foot careBilling 11721You need to document your class finds and have your Q modifiers correctDiagnosis needed:Must have diabetes diagnosisChoices:E11.40 DM2 Neuro CompE11.51 DM2 PVD CompE10.40 DM1 Neuro CompE10.51 DM1 PVD CompMust have Nail pathology
B35.1 Mycotic NailIf Neuro Modifier being used the DM diagnosis had it but would consider using G60.9 which is peripheral Neuropath
   Mycotic diabetic foot care for DM type 2 with neuro might look like
Procedure code: 11721 Q8Diagnosis codes:
E11.40B35.1G60.9Procedure Codes: 11055,11056 Q8Diagnosis codes:
E11.40B35.1G60.9L84


Mycotic diabetic foot care for DM type 2 with neuro might look like
    Procedure code: 11721 Q
    Diagnosis codes:
E11.51
B35.1
I73.9

Procedure Codes: 11055,11056 Q9
Diagnosis codes:
E11.51
B35.1
I73.9
L84

Mycotic diabetic foot care for DMtype1 with neuro might look like
Procedure code: 11721 Q8
Diagnosis codes:
E10.40
B35.1
G60.9

Procedure Codes: 11055,11056 Q8
Diagnosis codes:
E10.40
B35.1
G60.9
L84

Mycotic diabetic foot care for DM type1 with PVD might look like
Procedure code: 11721 Q9
Diagnosis codes:
E10.51
B35.1
I73.9

Procedure Codes: 11055,11056 Q9
Diagnosis codes:
E10.51
B35.1
I73.9
L84

If you are a practicing podiatrist seeing diabetic patients can decrease the possibility of them having a non traumatic amputation tremendously
In the study by Weck, et al, in Cardiovascular Diabetology, 2013. Instituting a structured diabetic foot program can yield a 75% reduction in amputation rates and a near four-fold reduction in inpatient mortality.
It has been proven time and time again in peer reviewed literature, that these patients who have diabetes that visit the podiatrist are much less likely to have an amputation of an extremity. 
 Podiatric medical care in people with history of diabetic foot ulcers can reduce the high level amputation between 65% and 80%. Gibson, et al, Int Wound Journal 2013. 
Ulcer diagnosis in diabetics
If your patient is Type 1 diabetic with an ulcer the diagnosis code is:  E10.622
If your patient is Type 2 diabetic with an ulcer the diagnosis code is: E11.622
These codes are the highest level of specificity for the types of Diabetic Ulcers we see in the office (do not confuse with pressure ulcers, different codes)
This is a good improvement, as all of the ulcer codes used to be jumbled together whether they were pressure, diabetic ect.
Coding for Diabetic Foot Ulcer debridement
11042, 11043 and 11042 use modifier L or R
There is no laterally in the diabetic ulcer codes themselves so laterally is still in your procedure codes
Diagnosis: 
E11.621 Type 2 dm with foot/ankle ulcer
E10.622 Type 1 dm with foot/ankle ulcer

To be specific as possible I would consider also coding their diabetes
Choices:
E11.40 DM2 Neuro Comp
E11.51 DM2 PVD Comp
E10.40 DM1 Neuro Comp
E10.51 DM1 PVD Comp

Yes they have diabetes and an ulcer. But documenting the DM2 Neuro E11.40, for example, is letting them know that the diagnosis of ulcer is “due to” the Neuro Complications
This makes this much more specific


Check out our website at: http://centeranklefootcare.com/catalog/c14_p1.html for a superbill for podiatry most common codes

10 comments:

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