Endocrine, Nutritional, and Metabolic Diseases

Endocrine, Nutritional, and Metabolic Diseases

1.60. E83.110

Rationale: The Alphabetic Index main term is Hemochromatosis, subterm hereditary (primary).

1.61. E86.0, E87.1

Rationale: Two separate codes should be assigned to fully capture the diagnoses. Follow the index under dehydration to get E86.0. Follow the index under hyponatremia to get E87.1.

1.62. E78.0

Rationale: The Alphabetic Index main term is Hypercholesterolemia. The term primary is listed in parentheses as a nonessential modifier.

1.63. b. Hyperaldosteronism

Rationale: The ICD-10-CM index also includes eponyms and provides clues to the nature of the disease. In this case, a description of the disease is also listed as secondary hyperaldosteronism. There are also listings under the main term Syndrome that are useful, in some cases, for locating a specific code. Code E26.81 is listed under Syndrome, Bartter’s.

1.64. E10.21, E10.65

Rationale: The ICD-10-CM classification for this diagnosis requires two codes. The Alphabetic Index main term is Diabetes, subterms Type I, with, nephropathy to represent the diabetic renal nephrosis. The Alphabetic Index main term is Diabetes, subterm, out of control, directs coders to the entry Diabetes, by type, with hyperglycemia.

1.65. E24.9 E08.9

Rationale: The Alphabetic Index main term is Diabetes, subterm due to underlying condition. The Alphabetic Index main term, Syndrome, subterm Cushing’s. Instructional notes at category E08 provide sequencing direction by stating, “Code first the underlying condition.”

1.66. E11.331

Rationale: The Alphabetic Index main term is Diabetes, subterms Type 2, with, retinopathy, nonproliferative, moderate, with macular edema.

1.67. E10.10

Rationale: The Alphabetic Index main term is Diabetes, diabetic, subterm Type 1, with, ketoacidosis. Per AHA Coding Clinic, 3rd Quarter 2013, it is not appropriate to also assign E10.65, Type I diabetes, with hyperglycemia. Ketoacidosis signifies uncontrolled diabetes.

1.68. E11.621, L97.422, Z79.4

Rationale: The Alphabetic Index main term is Diabetes, subterms Type 2, with, foot ulcer. A note under E11.621 instructs the coder to identify the site of the ulcer (L97.4-, L97.5-). Remember that coding guideline I.A.14 (CMS 2016a) states that the word “and” means “and” or “or.” Therefore, L97.422, Non-pressure chronic ulcer of left heel and midfoot with fat layer exposed, is the correct code. Also, under category E11, there is a note to code insulin use (Z79.4).

1.69. E89.1, Z90.410

Rationale: The Alphabetic Index main term is Hypoinsulinemia, postprocedural. The Tabular List reminds the coder to use an additional code (Z90.41-) to show acquired absence of the pancreas. The coder uses the Tabular List to complete the code.

1.70. d. All of the above

Rationale: Each condition mentioned is indexed and classified in ICD-10-CM to code E21.0, so the answer is all of the above.

1.71. E22.0

Rationale: The Alphabetic Index main term is Gigantism (hypophyseal).

1.72. E87.6

Rationale: The Alphabetic Index main term is Hypopotassemia. There are no subterms. Caution is required in assignment of codes based on abnormal findings without physician validation. If the condition is not listed in a diagnostic statement, the best practice is to ask the physician if the condition should be reported with a diagnosis code. Conditions that are integral to the disease process are not separately reported in ICD-10-CM (CMS 2016a, I.C.18.b.).