CDC issues 2018 ICD-10-CM guidelines errata

The Centers for Disease Control and Prevention (CDC), one of the Cooperating Parties responsible for the ICD-10-CM codes and guidelines, recently released a 2018 ICD-10-CM Official Guidelines for Coding and Reporting errata. Slight changes were made to the guidelines for diabetes, hypertension, and principal diagnosis selection.

The 2018 guidelines included an update for secondary diabetes mellitus that stated that “code Z79.4 should not be assigned if insulin is given temporarily to bring a type 2 patient’s blood sugar under control during an encounter.”

The revision replaces the phrase “type 2” with the word “secondary.” The guideline now states (emphasis added):

Secondary diabetes mellitus and the use of insulin or oral hypoglycemic drugs. For patients with secondary diabetes mellitus who routinely use insulin or oral hypoglycemic drugs, an additional code from category Z79 should be assigned to identify the long-term (current) use of insulin or oral hypoglycemic drugs. If the patient is treated with both oral medications and insulin, only the code for long-term (current) use of insulin should be assigned. Code Z79.4 should not be assigned if insulin is given temporarily to bring a secondary diabetic patient’s blood sugar under control during an encounter.

The guideline revision also correctly numbered the category for pulmonary hypertension as 11 under the subsection hypertension (a) in the section for Chapter 9: Diseases of the Circulatory System (I00-I99). Both hypertensive crisis and pulmonary hypertension were listed as number 10 under the hypertension category.

Under Section II, Selection of a Principal Diagnosis, the CDC added the words “is being provided” to the sentence “If the condition for which the rehabilitation service is no longer present, report the appropriate aftercare code as the first-listed or principal diagnosis, unless the rehabilitation service is being provided following an injury.”

The guideline now states (emphasis added):

If the condition for which the rehabilitation service is being provided is no longer present, report the appropriate aftercare code as the first-listed or principal diagnosis, unless the rehabilitation service is being provided following an injury. For rehabilitation services following active treatment of an injury, assign the injury code with the appropriate seventh character for subsequent encounter as the first-listed or principal diagnosis.

Read the full errata here and read more about the 2018 ICD-10-CM guidelines here.