Learn Insulin and Non Insulin Dependent Diabetes Mellitus 1 & 2 ICD-9 code

Insulin and Non Insulin Dependent Diabetes Mellitus 1 & 2 ICD-9 code
Insulin release from the Pancreas and how this lowers blood sugar leves. (Photo credit: Wikipedia)

What is Diabetes Mellitus?

A metabolic disorder because of the presence of high blood sugar in the blood leading to defects in the insulin secretions or its action or both is referred as diabetes mellitus. Insulin hormone secreted by pancreas lowers the blood glucose level, since the decrease in secretion of insulin or lack of response by the body cell to insulin hormone results in diabetes.   
                                            
A chronic condition with abnormal high level of sugar in the blood leads to diabetes. Diabetic patient are more susceptible to chronic condition and complication affecting primarily renal, vascular and nervous system of the body. Symptoms of diabetes include the increase urine output, thirst, hunger and fatigue. A diabetic diet with healthy balance diet with high in nutrients, low in fat and moderate in calories and pay more attention amount the carbohydrates you eat. 

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Insulin and non-insulin dependent Diabetes Mellitus Symptoms
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Types of diabetes mellitus

Type 1 diabetes – when the body fails to produce insulin it leads to type I diabetes also called Insulin dependent diabetes mellitus (IDDM) or Juvenile diabetes.       

Type 2 diabetes – when the body cells fails to respond to insulin properly it leads to type II diabetes also called Non-insulin dependent diabetes mellitus. This one occurs in adults. Mostly overweight people who do not do enough exercise leads to type II diabetes.
                                            

Gestational Diabetes – this happen in pregnant women without having any previous history of diabetes. Pregnant women developing high blood glucose level leads to gestational diabetes.



Learn how to code ICD 9 code for type 1 & 2 Diabetes Mellitus.

Diabetes coding in ICD-9 is not always satisfied by one diagnosis code. While coding diabetes one has to take care of complication/manifestations associated with diabetes mellitus. The documentation should indicate the cause and effect relationship between diabetic and the associated conditions of diabetes. Documentation that includes cause and effect relationship include “due to”, “caused by”, “with” and “secondary to”. When there is no cause and effect relationship codes the condition primary and diabetes as secondary.
Diabetes Mellitus codes come under category in ICD-9 book. The fifth digit in this category always tells you about the type of diabetes mellitus and controlled or uncontrolled. For fifth digit number for 0-3 are used which will specify the diabetes. The following fifth digits under category 250:
0-      Type II diabetes or unspecified type , not stated as uncontrolled
1-      Type I, juvenile type diabetes not stated as controlled
2-      Type II or unspecified type , controlled
3-      Type I, juvenile type , uncontrolled

When there is no mention of the type of diabetes the coding guideline tells us to take type II diabetes by default. While coding diabetes one should always code from 250 code category followed by the manifestation code. The book itself will lead and there will be note saying use additional code to code a manifestation code.
Secondary diabetes codes are given in ICD-9 book; these codes are in 249 code category. Secondary diabetes is caused by some other conditions such as cystic fibrosis, neoplasm of pancreas, adverse effect of drug). Assigning codes for secondary diabetes and its associated conditions the codes from the 249 category should be coded first followed by the diabetic manifestation codes. For example, secondary diabetes with diabetic nephrosis is assigned to code 249.40, followed by 581.81.
Now the 250 code category has different subcategory on the basis of manifestions
250.0x- diabetes mellituts without complication
250.1x- diabetes with ketoacidosis
250.2x- diabetes with hyperosmolarity
250.3x- diabetes with other coma
250.4x- diabetes with renal manifestation
250.5x- diabetes with ophthalmic manifestations
250.6x- diabetes with neurological manifestions
250.7x- diabetes with peripheral circulatory disorders
250.8x- diabetes with other manifestation.
These codes are coded as primary diabetes codes depending on the documentation followed by the manifestation code given below these codes.
Gestational diabetes occurs in the second and third trimester of pregnancy in women who are not diabetic prior to pregnancy. Gestational diabetes puts the women a greater risk of developing diabetes after the pregnancy. Women with unmanaged gestational diabetes have increased risk of developing type 2 diabetes mellitus. Gestational diabetes usually have no symptoms; hence pregnant women go for glucose-screening test between 24-28 weeks. Gestation diabetes is code to 648.8x, abnormal glucose tolerance.

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