Ch. 4 - N Codes | Endocrine, Nutritional, and Metabolic Diseases

Question 1

Two main types of DM

Answer 1

Primary and Secondary

Question 2

Diabetes type where it developed on its own

Answer 2

Primary diabetes

Question 3

Diabetes with an underlying cause/etiology

Answer 3

Secondary diabetes

Question 4

Category codes for primary diabetes and their descriptions

Answer 4

E10 - Type 1 diabetes
E11 - Type 2 diabetes

Question 5

Category codes for secondary diabetes

Answer 5

E08
E09
E13

Question 6

Drug-induced DM category code

Answer 6

E09

Question 7

DM due to underlying condition category code

Answer 7

E08

Question 8

DM other specified category code

Answer 8

E13

Question 9

Where does diabetes&raquo_space; insulin lead you to?

Answer 9

Type of diabetes

Question 10

These descriptors signal that the patient’s condition is DM with hyperglycemia as complication. 3 descriptors.

Answer 10

Out of control
Inadequately controlled
Poorly controlled

Question 11

This descriptor could either mean the patient either had a hyperglycemic or hypoglycemic complication.

Answer 11

Uncontrolled

Question 12

These two factors have no bearing on how diabetes is coded

Answer 12

Insulin-dependency and age

Question 13

Default code if no DM type is documented

Answer 13

E11

Question 14

These (name 3) are medications used long-term for the management of diabetes

Answer 14

Insulin
Oral hypoglycemic drugs
Injectable non-insulin antidiabetic drugs

Question 15

Some (3) key terms or clues that signify that the patient is using their medication as long-term management

Answer 15

Daily use
Maintenance
Self-administered

Question 16

Z code to report insulin use

Answer 16

Z79.4

Question 17

Z code to report oral hypoglycemic drug use

Answer 17

Z79.84

Question 18

Z code to report injectable non-insulin drug use

Answer 18

Z79.85

Question 19

During an encounter, when insulin is given temporarily to bring secondary DM patient’s blood sugar under control, what Z code will be used?

Answer 19

None.

Question 20

Hierarchy in reporting of long-term medications

?? > ?? > ??

Answer 20

Z79.4 > Z79.84 > Z79.85

Question 21

This kind of diabetes usually resolves after pregnancy.

Answer 21

Gestational diabetes

Question 22

Reporting / code stacking for pre-gestational Type 1 diabetes

[1] ?
[2] ?
[3] ?
[4] ?

Answer 22

O-E-Z(drug)-Z(week)

[1] O24.0- code
[2] E10- code
[3] Z79.- LT use of drug/maintenance
[4] Z3A.- gestation week code

Question 23

If the pregnant patient delivered during encounter:

1. What would be the last character of the O code be changed to?
2. What code to add for outcome of delivery?

Answer 23

1. Childbirth
2. Z37.-

Question 24

At least how many codes needed for pre-gestational diabetes reporting?

Answer 24

Two (O and E)

Question 25

With gestational diabetes, what would we include as a factor/code to report since they don’t have diabetes before (no diabetes type)?

Answer 25

Management of gestational DM

Question 26

Three ways gestational DM is managed (in hierarchical format from highest to lowest)

Answer 26

1. Controlled in part/total by insulin. 2. Controlled by oral hypoglycemic drug and/or diet. 3. Controlled by diet.

Question 27

If gestational DM patient is managing her DM via diet and insulin, how will you code?

Answer 27

Just code insulin.

Question 28

Category code for weeks of pregnancy

Answer 28

Z3A.--- (-- is number of weeks)

Question 29

For underdosing of insulin due to pump failure, how many codes can we expect and what do they reflect?

Answer 29

Four: [1] T code for mechanical complication. T85.6- [2] T code for underdosing of insulin. T38.3X6- [3] E code, appropriate. [4] Complications DUE to the underdosing

Question 30

How many codes can we expect for Type 1 DM and hyperglycemia and what is it called?

Answer 30

One. These are called combination codes. (E10.65)

Question 31

How is overdosing due to insulin pump failure code stacked? [1] ? [2] ? [3] ? [4] ?

Answer 31

[1] T code for mechanical complication. T85.614- [2] T code for POISONING by insulin and oral hypoglycemic drugs. T38.3X1A [3] E code, appropriate. [4] Complications DUE to the poisoning.

Question 32

Pancreas removal causes diabetes, 1. How many codes? 2. How to code stack?

Answer 32

Three codes. [1] E89.1 Postprocedural hypoinsulinemia [2] E13.- Other specified DM [3] Z90.41 Acquired absence of pancreas

Question 33

Coding sequence for secondary diabetes from an adverse effect of drug

Answer 33

[1] E09 - drug-induced DM code [2] Drug code

Question 34

Coding sequence for secondary diabetes from poisoning?

Answer 34

[1] Drug code [2] E09 - drug-induced DM code

Question 35

A patient ADJUSTING for their insulin dosage says what about the status of their medication?

Answer 35

It's for maintenance/long-term already. Them needing to adjust it = self-administered.

Question 36

This type of primary diabetes clues in that the pancreas is no longer functioning.

Answer 36

Type 1 DM