Endocrine

Question 1

Diabetes?

Answer 1

ALWAYS CODE!
- E11 type 1
- E12 type 2
- E13 - other
- E14 - Unspecified

Question 2

Initial DX of SDM

Answer 2

Assign E13 code

+ Y42.0 glucocorticoids causing adverse effects

ONLY TYPE OF DIABETES ALLOWABLE AS DX TYPE 2

Question 3

Hypoinsulinism due to pancreatectomy during episode of care where pancreatectomy took place

Answer 3

• E89.1 postprocedural hypoinsulinism
• Y83.6 removal of organ (partial, total, etc.)

Question 4

Hypoinsulinism due to pancreatectomy NOT during episode of care where pancreatectomy took place

Answer 4

Appropriate E13 code

Question 5

DM with poor control

Answer 5

• E1^.64 inadequate control
• mandatory assignment on admission or during episode of care
• never type 2 or 3
• never assign to newly dxed diabetics

Question 6

Insulin initiated for DM II during episode of care

Answer 6

-E11.64

Question 7

Diabetic coma/ketoacidosis

Answer 7

• Never assign inadequately controlled as it is already implied

Requires two codes:
Additional code to identify type of DM coma

Three types:
- hypoglycemic
- ketoacidosis
- hyperosmolar
- - hyperosmolar coma can occur in DM for reasons other than poor control. Do not assign diabetic coma in this case.

Question 8

Diabetic complications

Answer 8

• Cause and effect need not be established, to code as diabetic complication

Microvascular:
- kidneys, eyes, nervous system, skin, mucus membranes, musculoskeletal

Macrovascular:
- heart disease, stroke, PVD

Question 9

Multiple complications at least one meets clin. Sig.

Answer 9

Code each clinically significant complication separately!

Question 10

Multiple complications none meet clin. Sig.

Answer 10

Use -E1^.78 multiple complications

Question 11

Hypoglycemia

Answer 11

• E1^.63
  Code when documented with dm
  Can be dx type 2

Question 12

Lactic Acidosis as adverse reaction to metformin (glucophage)

Answer 12

-E1^. 11

+Y42.3 adverse effects insulin….

Question 13

DM w/o mention of complication

Answer 13

Can only be on same abstract as:
- E1^.1^
- E1^.63 hypoglycemia

Question 14

Dialysis

Answer 14

Must capture CCI code

Question 15

DM - ophthalmic complications

Answer 15

If retinopathy:
-H36.0*
- - with dagger code ahead

If senile or age related:
- E1^.38

If other type of cataracts:
- E1^.9

Question 16

DM - neurological complications

Answer 16

Somatic:
-peripheral
-cranial

-mononeuropathy - 1 nerve specified
- - G59.0*
Else
-polyneuropathy
- - G63.2*

Autonomic:
- nerves that control bodily function

Question 17

DM - angiopathy

Answer 17

E1^.5^ sequencing and dx typing rules for other complications do not apply, use standard dx typing rules and documentation to sequence and dx type.

Circulatory complications in DM = Macrovascular

Question 18

Borderline diabetes

Answer 18

Don’t exist, seek clarification in documentation.

May refer to mild DM, diet controlled DM, or glucose tolerance R73.0

Question 19

Obesity

Answer 19

Not mandatory for capture
- can be mrdx if admit for stomach reduction/gastric banding

Question 20

Dehydration

Answer 20

Only coded when condition in own right or when requires IV solution

Question 21

Thyroid crisis or storm

Answer 21

Assign code that describes any present type of thyrotoxicosis as well

• requires additional code for graves’ disease or hypothyroidism

Question 22

Neck dissection

Answer 22

Selective
- excision partial lymph node(s) cervical

Functional
- excision total lymph node(s) cervical

Modified Radical
- excision radical lymph node(s) cervical, modified radical neck dissection

Radical
- excision radical lymph node(s) cervical, radical neck dissection

Extended Radical
- excision radical lymph node(s) cervical, extended Radical neck dissection