Understanding ICD-9-CM Coding Mary Jo Bowie MS, RHIA, RHIT Regina Schaffer AAS, RHIA, CPC

Endocrine, Nutritional, and Metabolic Diseases and Immunity Disorders CHAPTER 8

Conditions Affecting Endocrine System Nutritional deficiencies unrelated to blood diseases Metabolic diseases Immunity disorders

Endocrine System Production and secretion of hormones Hormones allow for proper functioning of body Hormones are produced by different organs: Thyroid Pancreas

Thyroid Secretion of hormones regulate Growth Metabolism

Thyroid Conditions 240–246 Category Codes Goiter—lack of iodine Hypothyroidism—under-active thyroid Hyperthyroidism—over-active thyroid Thyrotoxic crisis—severe hyperthyroidism Thyroiditis—inflammation of thyroid gland

Pancreas Digestive enzymes Insulin production Regulates glucose levels Process glucose Regulates glucose levels Diabetes Mellitus Type I Type II

Diabetes Mellitus Type I (IDDM)—insufficient amount of insulin, if any at all Juvenile diabetes Juvenile onset Ketosis-prone Insulin injections are always needed.

Diabetes Mellitus Type II (NIDDM)—adult-onset diabetes Unable to produce sufficient amounts of insulin Develops later in life, usually May or may not be insulin-dependent Controlled by diet, exercise, and medications

Coding Diabetes Code as Type II if documentation does not identify type of diabetes Code selection from 250 category Fourth and fifth digits are always assigned Instructional notes are critical

Nutritional and Metabolic Deficiencies Vitamins—A, B, D, etc. Malnourished Malabsorption Lipid metabolism—hyperlipidemia Gout—gouty arthropathy Mineral metabolism

Nutritional and Metabolic Deficiencies Causes of nutritional and metabolic deficiencies in: Vitamins Minerals Proteins