Type 1 Diabetes with Diabetic Nephropathy and Hypertension Secondary to Renal Disease And

HS317b - Coding & Classification of Health Data

Lab - Endocrine

Examples:

Type 1 diabetes with diabetic nephropathy and hypertension secondary to renal disease and hypertension secondary to renal disease. FBS levels ranged from 6 to 9 mmol/L and were controlled with insulin.

PVD and gangrene due to NIDDM; diabetes controlled with insulin; FBS levels ranged from 6 to 11 mmol/L. The patient required amputation through metatarsophalangeal joint, left great toe with flap closure.

Uninodular toxic nodular goitre with thyrotoxicosis

Substernal partial right thyroidectomy

ESRD due to type 1 diabetic nephritic syndrome; diabetes controlled with insulin; FBS levels within controlled range.

Type 1 diabetic developed hypoglycaemia following insulin injection even though she had taken only the prescribed dose of insulin and did not alter her exercise or eating regimen.

Type 1 diabetes mellitus, controlled with insulin, diabetic osteoarthrosis, right knee

Procedures

Bypass Grafts (revascularization)

To code:

• Pay attention to anatomical sites
• Read inclusion or exclusion notes at the beginning of each anatomical site section.
• Bypass procedures of the arteries and veins are coded to the anatomical site in which the vessel originates

Aorto-femoral bypass graft, using left saphenous vein.

1.KA.76.MX-XX-A-//

1.KR.58.LA-L/

Bypass procedure involving the artieries, code to most proximal site. (originates in aorta; therefore code to aorta)

Autologenous veins…usually the saphenous vein. ---use to bypass occlusive lesions of the superficial femoral, popliteal or tibial arteries. Dacron is commonly used for an arterial prosthesis to bypass disease in the aortoiliac.

When resection is performed with a graft, the procedure is classified to partial excision of the artery with an appropriate qualifier to describe the type of material used for the repair.

Resection right anterior tibial artery with PTFE (polytetrafluoroethylene) graft.

1.KG.87.LA-XX-N-R/

Amputations: When the incision is made through bone

Disarticulation:When the incision is made through a joint

Below knee amputation:1.VQ.93.~~ Amputation tibia and fibula

Amputation through knee1.VG.93.~~

Debridement of ulcer of foot and ankle.

Debridement of ulcer based on intent and anatomical site (deepest involvement (skin or soft tissue which includes muscle, tendon))

Intent:

Dressing,

Repair,

Destruction

Partial excision

Radical excision

Minor Debridement of foot/ankle

1.WV.59.~~ Destruction, soft tissue foot and ankle

Excisional Debridement

1.WV.87.~~ Excision, partial soft tissue foot and ankle

Excision that involves removal of bone with other soft tissue

1.~~.91.~~ Excision, radical of bone + anatomical site.

Demonstrate in Folio where description of approaches are.