Icd-10 Code For Secondary Diabetes Mellitus Due To Pancreatic Malignancy

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Diagnosis Coding When You Can and Cannot Code the Diagnosis http://www.cco.us/medical-terminology... One of the questions that we get from new students is knowing when you can and cannot code the diagnosis. I think a lot of students, as soon as they learn how to look up codes, they are ready to code everything that they see. And every new student does it. I remember I did it. I wanted to call myself a supercoder because I wanted to code everything. It's fun to code. But you can't do that. You need to code only definitive diagnoses and they can be hard to identify. One of the things that you have to stay away from is equivocal language. When we say equivocal language, that means it's kind of on the fence. It's not a definite. It can go one way or the other. You have to stay away from that type of verbiage. Impending or threatened conditions, you'll see that, but that can be tricky. You cannot code something if it has not happened yet, in most cases. Now I know that sounds again, a little ambiguous, but if your physician documents, for example, we'll scroll down here just a bit... impending rupture of spleen due to enlarged spleen. Okay, impending tells you it's going to happen. The

Help With Diagnosis Coding Diabetes

If this is your first visit, be sure to check out the FAQ & read the forum rules . To view all forums, post or create a new thread, you must be an AAPC Member . If you are a member and have already registered for member area and forum access , you can log in by clicking here . If you've forgotten your username or password use our password reminder tool . To start viewing messages, select the forum that you want to visit from the selection below. How would you code Diabetes Mellitus coma due to malignant neoplasm of the pancreatic duct? I saw this on a test. Would you code 249.30, 157.3 or the other way around 157.3, 249.30? What is the reasoning for your decision? Thank you I would code 249.30, 157.3 because the neoplasm is what caused the diabetic coma so it should be sequenced second. read the diagnosis guidelines for secondary diabetes and sequencing. ICD-9 is different from ICD-10 on this. By [email protected] in forum Medical Coding General Discussion By kmelling in forum Medical Coding General Discussion By kumeena in forum Medical Coding General Discussion AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions Continue reading >>

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  1. dramalean

    Hey guys, I'm on a pretty strict ketosis diet and I feel great. But lately I have so much energy that I just can't seem to fall asleep anymore. Has anyone else experienced this? Should I up my carbs a bit? Any feedback is appreciated.

  2. rickkan

    My need for sleep went from 9 or 11 hours daily to 4 or 6... I had to get a second job to handle the extra free time and energy I had.

  3. TheGreatK

    This has happened to me too! I thought it was because I quit smoking cigarettes, but this makes more sense. I'm sleeping almost exactly five hours a night, and I feel great. Do you think there is any chance this is a bad thing, though? E.g. our sleep cycle is incomplete because of some deficiency? Or is the traditional recommendation of seven hours a night now outdated?

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ICD-10 Coding of Osteoarthritis | ICD-10 Coding Guidelines http://go.cco.us/icd-10-cm-full-course Chandra: A: For the ICD-10 for osteoarthritis, the guidelines actually state that you should use the multiple osteoarthritis code unless the specific codes are more appropriate for the circumstantial coding, and basically it comes down to the payer rules. If youre seeing a patient simply to manage their osteoarthritis and theyve got osteoarthritis in multiple joints, maybe they got in their left shoulder, their right shoulder, their left elbow and their left hip. Most providers are going to report that with a multiple osteoarthritis code. The times that you would break into the specific joint and laterality would be when youre trying to prove or substantiate medical necessity for certain things, like if you were evaluating a patient or planning to do a hip replacement on that same patient, they may have osteoarthritis and all these different joints but youre focused on the hip joint, specifically the left hip joint. So, your claim should have the specific code to say, Specifically were dealing with osteoarthritis of the left hip, then you could add additional codes, say they also have

Coding Guidelines For Diabetes Under Icd-10 | Acdis Blog

Book Excerpt: Coding guidelines for diabetes under ICD-10 The age of a patient is not the sole determining factor for the type of diabetes, although most Type 1 diabetics develop the condition before reaching puberty. For this reason, Type 1 diabetes mellitus is also referred to as juvenile diabetes. If the physician does not document the type of diabetes mellitus in the medical record, the default category of codes is E11 (type 2 diabetes mellitus). If the physician does not document the type of diabetes but does indicate that the patient uses insulin, assign a code from category E11; also report code Z79.4, long term (current use insulin to indicate that the patient uses insulin. Do not report code Z79.4 if a Type 2 patient is given insulin temporarily to bring his or her blood sugar under control during an encounter. In situations where diabetes occurs during pregnancy and for cases of gestational diabetes, refer to the ICD-10 Official Guidelines for Coding and Reporting Section I.C.15, Diabetes mellitus in pregnancy and gestational (pregnancy-induced) diabetes. The codes under category E08 (diabetes mellitus due to underlying condition) and E09 (drug or chemical induced diabet Continue reading >>

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  1. Equinox

    Hello, I am on day 17 of the Whole30, which I started in an attempt to get my rosacea under control. I am also interested in weight loss. Anyway, I can say that my pants are fitting a little looser since I started and my rosacea is better than it has been in a long time. So far I have tried to be as compliant as possible and my only two slips were accidental. I ate a sausage that had red wine on the ingredient list (I forgot that wine isn't allowed as I don't drink alcohol at all so I didn't register that part of the book as applying to me and just skimmed over it!). I also accidentally grabbed my daughter's glass instead of mine and got a small sip of lime-ade before I could spit it out. Those were in the first week though. I didn't bother starting again on Day 1 with these as I plan to be on the Whole30 for more than 30 days and counting things annoys me.
    On the other hand, my menstrual cycle (which arrived about 10 days in) was both heavier and longer than normal and I had terrible insomnia for a week beforehand. After my cycle began this eased off somewhat but I still have trouble falling asleep, staying a sleep and also with waking up too early. I feel like a zombie and I'm averaging about 5 hours of poor quality sleep a night. I've had to stop my regular exercise routine as I'm just too tired. I should mention that I'm usually a good sleeper, except when my daughter wakes me up in the night, which unfortunately happens a couple of times a week these days. And that happened more than the usual number of times in the past two weeks so my sudden insomnia has been all the worse. This is seriously the worst quality sleep I have ever gotten in my life that was not caused by some external factor (like having a newborn). I just toss and turn and feel really anxious over nothing at all.
    It seems that some other people have experienced this with the Whole30 as well. I'm wondering if I've entered into ketosis, which I read was associated with insomnia in some people, especially women. I just weighed myself to see if I had any sort of profound weight loss that might explain it and it seems I've lost 4 lbs, which is more than usual for me but certainly not beyond the pale. So, assuming that I have not been eating enough starch (I've been trying to eat a starchy vegetable once a day and eating a banana once a day also), how long will it take to get out of ketosis if I start adding a starchy vegetable to each of my three meals? I should add that even though I maybe haven't been getting enough starch, I haven't been hungry at all and I didn't experience any cravings at all until the sleep deprivation started to kick in. Also, has anyone had success with melatonin?
    I just really want to get a good night's sleep.

  2. missmary

    I would not recommend melatonin as a long-term solution because it interferes with your bodies ability to produce melatonin on it's own. Magnesium is a great supplement that can help with sleep.
    If you already have included starchy veggies and bananas every day, ketosis is very unlikely. Regardless, starchy veggies can certainly help with sleep and anxiety issues, especially when consumed at meal #3. How is your fat intake? Make sure you keep that at least to the minimum recommended 1-2 thumbs per meal (don't rely on cooking fat alone, since much of that stays in the pan).
    Eating within an hour of waking and also getting sunlight right away in the morning (go outdoors for 15 minutes) can really help with getting cortisol in the right rhythm which will help with sleep. In the same vein, avoiding bright light and screens at night will also help keep circadian rhythms in proper order. Some people use amber glasses or software like f.lux to reduce blue light at night for a similar effect.
    Good luck. I hope you get some better sleep soon!

  3. Tom Denham

    I am one of those people who needs starchy veggies every day to keep me sleeping good. I've also had a great experience with taking magnesium. I used to take Natural Calm, but it provoked diarrhea for me. I switched to magnesium aspartate supplements - 200 to 300 mgs per night. It is working very well. Actually, when I first saw a functional medicine doctor, she gave me an injection of magnesium and I enjoyed great sleep that night and for the next several nights.

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Please *LIKE || COMMENT | | SHARE | | SUBSCRIBE* to support this channel. For more info visit http://www.DiseasesAndTreatment.com/ ====================================== pancreatic cancer, CANCER OF PACREASE, exocrine pancreatic cancer, endocrine pancreatic cancer, Glucagonoma, Insulinoma, Gastrinoma, Somatostatinoma, ======================================

Pancreatic Cancer: Practice Essentials, Background, Pathophysiology

Pancreatic cancer is the fourth leading cause of cancer deaths, being responsible for 7% of all cancer-related deaths in both men and women. Approximately 75% of all pancreatic carcinomas occur within the head or neck of the pancreas, 15-20% occur in the body of the pancreas, and 5-10% occur in the tail. See the image below. Pancreatic cancer. Gross section of an adenocarcinoma of the pancreas measuring 5 X 6 cm resected from the pancreatic body and tail. Although the tumor was considered to have been fully resected and had not spread to any nodes, the patient died of recurrent cancer within 1 year. The initial symptoms of pancreatic cancer are often quite nonspecific and subtle in onset. Patients typically report the gradual onset of nonspecific symptoms such as anorexia, malaise, nausea, fatigue, and midepigastric or back pain. Patients with pancreatic cancer may present with the following signs and symptoms: Significant weight loss: Characteristic feature of pancreatic cancer Midepigastric pain: Common symptom of pancreatic cancer, sometimes with radiation of the pain to the midback or lower-back region Often, unrelenting pain: Nighttime pain often a predominant complaint Onset Continue reading >>

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  1. Jen100

    > Bladder Pain and Ketosis

    I dont know if I am imagining this or not but, but everytime I go into Ketosis, my bladder seems to hurt. Does anyone know if bladder pain can be a symptom of ketosis?? I have bladder pain and some burning sensations when I pee (I know this is a symptom of bladder infection too, but it seems to come and go with ketosis)

  2. mj's page

    Is it possible that you're reading a strong positive for ketosis partially because you're not drinking enough?

  3. Deezil

    Well, I googled 'bladder pain and ketosis' and came across this blurb..
    Ketosis is a metabolic state in which the body produces ketones to be used as fuel by some organs so that glycogen can be reserved for organs that depend on it. It is important when looking for information on ketosis that it is not confused for ketoacidosis - a very unhealthy state of being. It is unfortunately all too common for information sources to conflate these two and thus pronounce ketosis as bad.
    Because glucose is commonly accepted as the body's primary fuel source, putting the body into a state where burning something other than glucose for fuel is subsequently regarded as a form of starvation. Yet, the human body has a well-defined mechanism for literally burning fat for fuel (I think it's important to realize that even in the presence of glucose, some tissues in the human body still prefer to use fat for fuel. Ironically, the heart is one of those, despite the fact that the intended purpose of low-fat diets is to save your heart). When the body uses fat as energy, it's in a state of ketosis.
    When you stop eating glucose (ie: carbohydrates), your body begins the process of ketosis. In ketosis, the liver starts unpacking fat cells so that your body can use the fatty acids for fuel. It also produces ketone bodies, which the body also uses for fuel - especially the brain. The benefits of ketosis are numerous - lowered blood pressure, lower cholesterol, low triglycerides, improved insulin sensitivity, and weight loss without regard to calorie count. Other reported benefits are common - lack of hunger, lack of cravings, improved mood, lessened anxiety, and greater mental concentration. Variations on ketogenic diets are used to control various medical conditions including acne, heartburn and acid reflux, thyroid problems, epilepsy, and type 2 diabetes.
    Negative side effects of a ketogenic diet include light-headedness, headache, lethargy, weakness, feeling cold, diarrhea, and nausea. These side effects are only temporary and go away once the body has fully made the switch from burning glucose to burning fat (within the first week). They are almost universally acknowleged as symptoms of withdrawal from sugar.
    The body is very capable of regulating ketone bodies, so unless there is a major problem (Alcoholics and type 1 diabetics often have problems with ketone regulation), you should be just fine. For those people who do have a major problem, however, they can develop ketoacidosis. Essentially, their bodies no longer regulate the ketones in their blood, and they start building up. The more they build up, the more they change the acidity of the blood in your body, and that's very dangerous. The complications of ketoacidosis include halitosis, extreme thirst, frequent urination, contant fatigue, dry skin, abdominal pain, difficulty breathing, and mental confusion.
    If you're looking to lose weight without eating less, improve your mood and mental acuity, or even to solve some common health issues like acne or acid reflux, a ketogenic diet (also called a homeostatic diet) may be exactly the right tool for you. Just keep an eye out for the symptoms of ketoacidosis, and you should have no problems at all once you get past those nasty withdrawal symptoms.

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