NOTE: All in-article links open in a new tab.

Inpatient FAQ August 2018

Published on 

Tuesday, July 31, 2018

 | RAC Information 
 | FAQ 

Q:

Is the “with” guideline used when there is documentation of Diabetes and Arthritis?


A:

No, the “with” guideline does not apply to “not elsewhere classified” (NEC) conditions. Arthritis, a form of Arthropathy, can be due to many other conditions besides Diabetes. Therefore, coders should not assume a cause and effect relationship between Diabetes and a “NEC” condition. The physician would have to document Arthritis as a diabetic complication in order for E11.618 to be assigned.

Diabetes, diabetic (mellitus) (sugar)

with

arthropathy NEC E11.618

References:

Coding Clinic: Second Quarter 2018, page 6

Fourth Quarter 2017, page 100-101

Article Author: Anita Meyers, RHIT, CCS
Anita Meyers, RHIT, CCS, is an Inpatient Coding Professional at Medical Management Plus. Anita has over twenty-six years of experience in inpatient and outpatient coding including 17 years of work at AQAF reviewing inpatient and outpatient records from Alabama hospitals. In addition to reviewing records she was the team leader in Beneficiary Services where she participated in case review activities, received and processed beneficiary complaints and handled fee-for-service denials for home health, hospice and skilled nursing facility services. Prior to joining the MMP team, Anita left AQAF to become an inpatient contract coder and worked at various hospitals in central Alabama. In her current position, Anita is an integral part of the Inpatient Services at Medical Management Plus.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.