July Coding Tip Corner

When coding a patient with a diagnosis of Diabetes with Chronic Kidney Disease (CKD), two codes are needed:

• either E10.22 for type 1 diabetes or E11.22 for type 2 diabetes
• the stage of the CKD (a code from category N18 and its subcategories: N18.1-N18.6)

If the stage is not specified, you can query the provider. If necessary, N18.9 is reserved for unspecified CKD, however, the stage should be determined through testing.

Some reminders about diabetes and hypertension:

• ICD-10 does not assume a causal relationship between diabetes and hypertension. Therefore, unless the provider documents a link, they should be coded separately.
• If the provider documents diabetes is causing hypertension, then hypertension can be coded as a circulatory complication of diabetes, such as E11.59 or I15.2.

It’s important to note: The concept of risk adjustment is used by health plans and organizations like CMS to predict healthcare costs based on a patient’s health status. The accuracy of diagnosis coding directly impacts this process, affecting reimbursement and highlighting the importance of capturing a complete and accurate picture of a patient’s medical conditions.