Reporting Diabetic Ketoacidosis with the Correct ICD-10 Codes

Reporting Diabetic Ketoacidosis with the Correct ICD-10 Codes Reporting Diabetic Ketoacidosis (DKA) with the Correct ICD-10 Codes

Reporting Diabetic Ketoacidosis can occur when your blood sugar level is too high for too long. The article lists the symptoms, diagnosis and ICD-10 codes for the same.

Outsource Strategies International 8596 E. 101st Street, Suite H Tulsa, OK 74133

Diabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes that occurs when your body produces high levels of blood acids called ketones. Most commonly occurring among patients with Type 1diabetes (but can sometimes occur in people with Type 2 diabetes), DKA develops when your body cannot produce enough insulin. Insulin plays a key role in helping glucose (a main source of energy for your muscles and other tissues) to enter your cells. Without adequate insulin, your body begins to break down fat as fuel, which in turn produces a buildup of acids in the bloodstream (called ketones) eventually leading to diabetic ketoacidosis.

Excess ketones build up and are spilled over into the urine. If left untreated, ketones can build up to dangerous levels causing severe complications like diabetic coma or even death. The condition is usually triggered by injury, infection or other illness, missed or inadequate insulin therapy, heart attack, use of certain medications (such as corticosteroids and some diuretics), binge drinking, illegal drugs usage and physical or emotional trauma. However, in some cases there are no obvious triggers. Endocrinology medical billing and coding is a complex procedure. Physicians need to be ready with the correct ICD-10 codes for this diabetes related condition and medical coding outsourcing to an experienced service provider is a reliable strategy to ensure this.

Warning Signs and Symptoms Often, the signs and symptoms of DKA develop quickly, sometimes within 24 hours. However, in some cases these signs and symptoms may be the first indication of having diabetes. People with high blood sugar levels above 240

www.outsourcestrategies.com

918-221-7769

mg/dL or with symptoms like - dry mouth, feeling really thirsty, or frequent urination need to check for ketones. Ketones in blood/urine are easily detected by a simple urine or blood test, using strips available on prescription. Other related signs and symptoms include –  Nausea and vomiting  Abdominal pain  Weakness or fatigue  Shortness of breath  Fruity-scented breath  Confusion  Blurry vision  Collapse/unconsciousness  Deep or fast breathing  Feeling very tired or sleepy  High blood sugar level and ketone levels in your urine If left untreated, the risks associated with this condition are higher and can lead to loss of consciousness and even death. The risk of developing DKA is higher in people who have – Type 1 diabetes, people below the age group of 19 years, have had a heart attack or stroke, have a drug or alcohol addiction or have had some form of trauma, (whether emotional or physical).

How to Diagnose and Treat DKA? As part of the initial diagnosis, the physician will conduct a detailed physical examination and blood acidity tests and sugar levels to confirm the condition. www.outsourcestrategies.com

918-221-7769

Testing for ketones in a sample of urine is one of the first steps for diagnosing DKA. In addition, physicians may conduct other additional tests to identify underlying health problems that might have contributed to diabetic ketoacidosis and to check for complications. Other additional tests include –  A basic blood panel (including potassium and sodium, to assess metabolic function)  Arterial blood gas to determine the acidity of your blood  Blood pressure measurement  Blood electrolyte tests  Urinalysis  Chest X-ray  A recording of the electrical activity of the heart (electrocardiogram) The treatment for this condition involves a combination of several modalities in order to normalize abnormal blood sugar and insulin levels. For people who are diagnosed with DKA, but not yet been diagnosed with diabetes, the physician will create a specific treatment plan to keep ketoacidosis from recurring. Treatment usually includes fluid replacement, electrolyte replacement and insulin therapy. Endocrinologists or other physicians offering treatment for DKA have to report the correct diagnostic and procedural codes on the medical claims to obtain due coverage. Medical billing and coding services offered by experienced providers ensure that the correct ICD-10 codes are used for medical billing purposes.

Earlier, Type 2 diabetic ketoacidosis DKA was reported with codes –

www.outsourcestrategies.com

918-221-7769

E13.1 - Other specified diabetes mellitus with ketoacidosis  E13.10 - Other specified diabetes mellitus with ketoacidosis, without coma  E13.11 - Other specified diabetes mellitus with ketoacidosis, with coma However, for FY2018, there is a new code specifically for reporting this diagnosis– E11.1 - Type 2 diabetes mellitus with ketoacidosis  E11.10 - Type 2 diabetes mellitus with ketoacidosis, without coma  E11.11 - Type 2 diabetes mellitus with ketoacidosis, with coma Proper management of diabetes is one of the top ways to prevent the occurrence of diabetic ketoacidosis (DKA). Patients must make healthy eating and physical activity a part of their daily routine. They should take oral diabetes medications or insulin as directed. Careful and consistent monitoring of blood glucose levels at regular intervals may help control blood sugar levels. Other prevention methods include - adjusting insulin dosage levels (based on the person’s activity level, illnesses, or other factors), never skipping insulin doses and regular testing of urine for ketone levels during periods of high stress or illness.

Medical coding for diabetic ketoacidosis (DKA) can be challenging.

Outsourcing medical coding to a reliable medical billing and coding company (that provides the services of AAPC-certified coding specialists), can help healthcare providers ensure correct and timely medical billing and claims submission. www.outsourcestrategies.com

918-221-7769