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Icd 10 Type 1 Diabetes With Retinopathy

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2018 Icd-10-cm Diagnosis Code E10.39

Type 1 diabetes mellitus with other diabetic ophthalmic complication E10.39 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Type 1 diabetes w oth diabetic ophthalmic complication The 2018 edition of ICD-10-CM E10.39 became effective on October 1, 2017. This is the American ICD-10-CM version of E10.39 - other international versions of ICD-10 E10.39 may differ. Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifest Continue reading >>

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  1. Laurie R Zawiskie, RHIT

    Has anyone tried to code DKA in a patient with DM 2? The 3M encoder takes you to the code for secondary/other diabetes and then when you try to code other diabetic manifestations you get an excludes 1 notes saying they can't be coded with other diabetes. My code book is a 2014 draft, so I don't know if this has been corrected in the 2015 version, but there is not an entry for DM 2 with DKA. I think the 3M encoder is wrong to code it as secondary/other diabetes, but I can't find another way to code it.

  2. Lynn M Farnung

    Laurie,
    There is a Coding Clinic that addresses the type of DM with DKA. I have pasted it below.
    Diabetes mellitus with diabetic ketoacidosis
    Coding Clinic, First Quarter 2013 Page: 26-27 Effective with discharges: March 27, 2013
    Related Information
    Question:
    What is the correct code assignment for type 2 diabetes mellitus with diabetic ketoacidosis?
    Answer:
    Assign code E13.10, Other specified diabetes mellitus with ketoacidosis without coma, for a patient with type 2 diabetes with ketoacidosis. Given the less than perfect limited choices, it was felt that it would be clinically important to identify the fact that the patient has ketoacidosis. The National Center for Health Statistics (NCHS), who has oversight for volumes I and II of ICD-10-CM, has agreed to consider a future ICD-10-CM Coordination and Maintenance Committee meeting proposal.
    © Copyright 1984-2015, American Hospital Association ("AHA"), Chicago, Illinois. Reproduced with permission. No portion of this publication may be copied without the express, written consent of AHA. ------------------------------
    Lynn Farnung
    Inpatient/Outpatient coder, AHIMA Approved ICD-10 Trainer
    Original Message

  3. Laurie R Zawiskie, RHIT

    Thanks, Lynn. If a patient also has DM 2 w/nephropathy (E11.21), I guess we will have to ignore the Excludes 1 note that says E13.10 can't be coded with Type 2 DM (E11.-).
    ------------------------------
    Laurie Zawiskie
    Coder III
    Original Message

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Today I introduce you to ICD-10-CM and ICD-10-PCS. I also give you a website, www.cms.hhs.gov, where you can download the ICD-10-CM Official Coding Guidelines. My e-mail address is: [email protected] https://www.cms.gov/

Draft Icd-10-cm/pcs Ms-drgv28 Definitions Manual

Draft ICD-10-CM/PCS MS-DRGv28 Definitions Manual Appendix C: Principal diagnoses which convert CC/MCC to non-CC Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) Diabetes mellitus due to underlying condition with hyperosmolarity with coma Diabetes mellitus due to underlying condition with ketoacidosis without coma Diabetes mellitus due to underlying condition with ketoacidosis with coma Diabetes mellitus due to underlying condition with diabetic nephropathy Diabetes mellitus due to underlying condition with diabetic chronic kidney disease Diabetes mellitus due to underlying condition with other diabetic kidney complication Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema Diabetes mellitus due to underlying condition with mod Continue reading >>

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  1. bigmama5

    How do I know when I am there or not, where can find this out my coach has given no information on this.

  2. glenlorie

    Although I don't look for ketosis, I have done a lot of research and they most common thing that many of my weight loss friends use is a stick that is similar to a EPT (pregnancy test). A few of them said they purchase them from walmart, however I've never seen them there. A lot of them also order them online, so I'm sure if you do some online research you can find them. I hope this helps. Best wishes!!

  3. JerseyGyrl

    The ketosis sticks do not work for everyone....I 've lost over 100 lbs on Atkins and they never changed color for me. They are also pretty costly.
    Key signs of ketosis are bad breath, a metallic taste in the mouth, foul smelling urine and thirst.

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http://www.icd10forkindergarten.com http://www.pacecoding.com

Icd-10 Charts

E13.0Other specified diabetes mellitus with hyperosmolarity 249.20 250.20E13.00Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) 249.20 250.20E13.01Other specified diabetes mellitus with hyperosmolarity with coma E13.1Other specified diabetes mellitus with ketoacidosis 249.10 250.10E13.10Other specified diabetes mellitus with ketoacidosis without coma 249.30 250.30E13.11Other specified diabetes mellitus with ketoacidosis with coma E13.2Other specified diabetes mellitus with kidney complications 249.40 250.40E13.21Other specified diabetes mellitus with diabetic nephropathy 249.40 250.40E13.22Other specified diabetes mellitus with diabetic chronic kidney disease 249.40 250.40E13.29Other specified diabetes mellitus with other diabetic kidney complication E13.3Other specified diabetes mellitus with ophthalmic complications E13.31Other specified diabetes mellitus with unspecified diabetic retinopathy 249.50 250.50 362.01 362.07E13.311Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema 249.50 250.50 362.01E13.319Other specified diabetes mellitus with unspecified diabetic retinopathy wi Continue reading >>

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  1. Khan

    An aldehyde group can easily be reduced to an alcohol using the mild reducing agent

    NaBH


    4
    NaBHX4 at low temperature in the presence of a ketone group. This chemoselectivity is due to the fact that an aldehyde is less sterically hindered compared to a ketone, which makes it react faster than the ketone.
    Is it possible, however, to chemoselectively reduce a ketone in the presence of an aldehyde using

    NaBH


    4
    NaBHX4 as reducing agent?

  2. Curt F.

    The best strategy is probably to chemoselectively protect the aldehyde before the borohydride reduction. Protecting groups are derivatives of certain moieties in a molecule that are far less reactive under most conditions, but which can be easily removed under very specific conditions to regenerate the original moiety.
    For carbonyl compounds -- this includes both aldehydes and ketones -- the most common protecting groups are all introduced by ketalization/acetalization. Common examples are dimethyl acetals, 1,3-dioxolanes, and 1,3-dioxanes.
    However, in general, aldehydes are far more prone to acetalization than ketones are to ketalization. That offers a means to chemoselectively protect aldehydes. Acetals such as 1,3-dioxanes are stable to borohydride reductions, but, as you note in your question, ketones are sensitive.
    Poking around reveals several potential strategies for selective chemoprotection of an aldehyde. Here are two examples.
    Tetrabutylammonium Tribromide (TBATB) as An Efficient Generator of HBr for an Efficient Chemoselective Reagent for Acetalization of Carbonyl Compounds:

    This convenient, mild, chemoselective method allows acetalization of an aldehyde in the presence of ketone...

    Chemoselective Protection of Aldehydes in the Presence of Ketones Using RuPVP Complex as a Heterogeneous Catalyst
    Putting it all together, a recipe for selective borohydride reduction of a ketone in the presence of an aldehyde would be something like:

    Protect the aldehyde. The best choice is probably as a 1,3-dioxane acetal by reacting your compound with 4 equivalents of 1,3-propanediol, 1 equivalent of triethyl orthoformate, and 0.01 equivalent of tetrabutylammonium tribromide. Under suitable conditions, the ratio of protected aldehyde (desired) to protected ketone (undesired) should be >50.

    Borohydride reduction of the aldehyde-protected compound. Only the unprotected ketone will react.

    Deprotection. Acetals can be removed in acidic conditions. A number of catalysts that will effect deprotection without requiring acid have also been developed.

  3. Jan

    An easy and convenient method to achieve this is the use of the Luche reduction.[1,2]
    The ‘organic chemist’s bible’, Strategic Applications of Named Reactions in Organic Synthesis by L. Kürti and B. Czakó notes on the page of the Luche reduction (p. 268):
    8) the combination of

    CeCl


    3/NaBH


    4
    CeClX3/NaBHX4 is excellent for the chemoselective reduction of ketones in the presence of aldehydes, since under these conditions aldehydes undergo rapid acetalization, which prevents their reduction.
    Indeed, when a

    1 : 1
    1:1 mixture of hexanal and cyclohexanone is subjected to Luche conditions with

    1.5 eq
    1.5 eq of

    NaBH


    4
    NaBHX4, a quantitative yield of cyclohexanol and a nigh-quantitative (

    98 %
    98 %) of hexanal are recovered. Without the addition of

    CeCl


    3
    CeClX3,

    1.5 eq
    1.5 eq reduce cyclohexanone quantitatively and

    49 %
    49 % of hexan-1-ol are also recovered.[1]
    Reference and note:
    [1]: J. L. Luche, A. L. Gemal, J. Am. Chem. Soc. 1979, 101, 5848. DOI: 10.1021/ja00513a075.
    [2]: The article [1] is only two pages short. The first page is displayed as an ‘abstract’ on pubs.acs.org (‘in lieu of an abstract’, ibid.). Thus, opening the abstract of S. Nagase, T. Fueno, K. Morokama, J. Am. Chem. Soc. 1979, 101, 5849 (DOI: 10.1021/ja00513a076) can serve as a cheap hack to see the entire article.

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