ICD Code E11.22

ICD code E11.22 is used to identify a diagnosis of Type 2 diabetes mellitus with diabetic chronic kidney disease. This code indicates that the patient has Type 2 diabetes and is experiencing chronic kidney disease as a complication of their diabetes. It is important for healthcare providers to use this specific code to ensure accurate documentation and billing, as well as to facilitate appropriate treatment and management of the patient's condition.

1. Diagnosis of Type 2 Diabetes Mellitus: Confirmed diagnosis of Type 2 diabetes mellitus, typically characterized by insulin resistance and relative insulin deficiency. This diagnosis is often supported by elevated blood glucose levels, HbA1c levels, and clinical evaluation.

2. Presence of Chronic Kidney Disease (CKD): Evidence of chronic kidney disease, which may include persistent reduction in kidney function or structural kidney damage lasting for more than three months. This is often indicated by a decreased glomerular filtration rate (GFR) and/or the presence of albuminuria.

3. Link Between Diabetes and CKD: Establish a causal relationship between the Type 2 diabetes mellitus and the chronic kidney disease. This involves clinical documentation that the CKD is a complication resulting from the diabetes.

4. Clinical Symptoms and Laboratory Findings: Document symptoms and laboratory findings consistent with diabetic chronic kidney disease, such as proteinuria, elevated serum creatinine, and reduced GFR. Other symptoms may include fatigue, swelling in the extremities, and changes in urination patterns.

5. Exclusion of Other Causes: Rule out other potential causes of chronic kidney disease that are not related to diabetes, ensuring that the CKD is indeed a complication of the diabetes.

6. Ongoing Monitoring and Management: Evidence of ongoing monitoring and management of both diabetes and CKD, including regular blood tests, kidney function tests, and adjustments in treatment plans to manage both conditions effectively.

For the ICD code E11.22, which pertains to type 2 diabetes mellitus with diabetic chronic kidney disease, the relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99215: Evaluation and Management (E/M) codes for office or other outpatient visits, depending on the complexity and time spent with the patient.

2. 80047-80076: Basic metabolic panel and comprehensive metabolic panel codes, which may be used for laboratory tests to monitor kidney function and overall metabolic status.

3. 82043: Albumin, microalbumin, quantitative test, which is often used to assess kidney function in diabetic patients.

4. 82565: Creatinine; blood test, which is essential for evaluating kidney function.

5. G0431: Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GCMS), which may be relevant if medication management is part of the treatment plan.

6. 90935-90999: Dialysis services, if the patient requires dialysis due to advanced chronic kidney disease.

7. 83036: Hemoglobin A1c test, which is crucial for monitoring long-term glucose control in diabetic patients.

8. 99217-99220: Observation care discharge services, if the patient is admitted for observation related to their condition.

9. 99495-99496: Transitional care management services, which may be applicable if the patient is transitioning from a hospital or other healthcare facility to home care.

These CPT codes are examples of the types of services that may be billed when managing a patient with the ICD code E11.22. The specific codes used will depend on the individual patient's treatment plan and the services provided.

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