Physicians no longer need to confirm a link between diabetes and any condition that appears as a potential manifestation of diabetes in the ICD-10 Index below diabetes' subentry "with."
"Coders should assign ANY diabetes manifestation listed under the main term ‘diabetes, followed by the subentry ‘with’ as being associated with or due to, without the physician stating the conditions are linked, unless the physician states they are unrelated," announced Trish Twombly, CEO for both the Board of Medical Specialty Coding and Compliance (BMSC) and the Association of Home Health Coding and Compliance (AHCC) in an email to AHCC members May 13.
DecisionHealth and the AHCC board sought clarification after the first-quarter edition of the American Hospital Association's "Coding Clinic" revealed this new guidance.
"The guidance clarification indicates when the main term ‘Diabetes’ in the Index, has a sub entry of ‘with’" Twombly explained in the message, "that any of the conditions under that subterm “with” such as gangrene, neuropathy, or amyotrophy can be coded without the physician stating that these conditions are linked."
Of course, this raises questions about what "with" means in other instances wherein two conditions may or may not be related.
The AHA promised the AHCC board and DecisionHealth more clarification in the "Coding Clinic" second-quarter edition, Twombly said.