AHIMA has clarified coding of Diabetes and assumed manifestations, and QIRT will adjust coding practices accordingly. As of today, May 23, 2016, QIRT will code Diabetes and assumed manifestations per AHIMA clarification. The guidance is in relation to the use of the subterm “with” in the alpha index.
The ICD-10-CM Official Guidelines for Coding and Reporting states the following at Section I.A.15:
- The word “with” should be interpreted to mean “associated with” or “due to” when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List.
- The word “with” in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.
AHA Coding Clinic has confirmed that any conditions listed following the indented subterm “with” under Diabetes is to be interrupted as a link between the manifestation and Diabetes as long as no other reason has been stated for the manifestation.
See below. All the conditions listed from amyotrophy to skin ulcer are assumed manifestations of the Diabetes unless another cause is listed. Please note that Osteomyelitis is not included on this list. Please see below for the subterm list associated with E11.9:
AHIMA has explained it very well in the following link: http://journal.ahima.org/2016/05/11/coding-diabetes-mellitus-with-associated-conditions/