Q&A: Reporting diabetes with arteriosclerotic PAD in ICD-10-CM

Q: When a diabetic patient has arteriosclerotic peripheral artery disease (PAD), should an additional ICD-10-CM code be assigned from subcategory I70.2- (atherosclerosis of native arteries of extremities) to describe the affected vessel and laterality?

A: Yes. According to Coding Clinic, Third Quarter 2018, you should assign ICD-10-CM code E11.51 (Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene) along with an additional code from subcategory I70.2- to fully capture the patient's condition.

A code from category I70.2- can only be reported when the documentation provides specificity about the atherosclerosis such as laterality, affected vessel, as well as additional manifestations of the disease (i.e., claudication, rest pain, etc.).

Keep in mind that according to the 2020 ICD-10-CM Official Guidelines for Coding and Reporting, multiple codes should not be used when the classification provides a combination code that clearly identifies all of the elements documented in the diagnosis.

“When the combination code lacks necessary specificity in describing the manifestation or complication, an additional code should be used as a secondary code,” the guidelines say.

Editor’s note: Sarah Humbert, RHIA, AHIMA-certified ICD-10-CM/PCS trainer, coding and compliance manager at KIWI-TEK LLC, and Temeka Davis, RHIT, coding manager at KIWI-TEK LLC, answered this question during HCPro’s webinar Simplify Complex ICD-10-CM Coding for Diabetes.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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