Secondary Diabetes in ICD-9-CM Summary of Proposals ICD-9-CM Coordination and Maintenance Committee National Center for Health Statistics Centers for Disease.

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Presentation transcript:

Secondary Diabetes in ICD-9-CM Summary of Proposals ICD-9-CM Coordination and Maintenance Committee National Center for Health Statistics Centers for Disease Control and Prevention March 23, 2007

Overview of C&M Proposals First proposal (4/04) First proposal (4/04) Request for code to identify secondary diabetes due to cystic fibrosisRequest for code to identify secondary diabetes due to cystic fibrosis Second proposal (10/04) Second proposal (10/04) Third proposal (3/06) Third proposal (3/06) Fourth proposal (9/06) Fourth proposal (9/06)

April 2004 Create new fifth digits for secondary diabetes 250 Diabetes mellitus “4” secondary diabetes, not stated as controlled “5” secondary diabetes, uncontrolled  Comments: extremely unpopular; confusing; needs its own code(s); negative impact on statistical data; not supported by CDC Diabetes Program or NIH Diabetes Institute

October 2004 Create new subcategory 251 Other disorders of pancreatic internal secretion Secondary diabetes mellitus Code first underlying disorder  Comments: create new code for diabetes due to drugs; add note for long-term use of insulin

March 2006 Create new category 249 Diabetes mellitus due to underlying condition – – (Codes parallel code 250 w/o 5 th digits)  Comments: Bring full proposal (tabular and index changes) to 9/06 C&M meeting

Overview of 9/06 Comments Confusing instructional notes: code first vs. use additional depending on causal condition Confusing instructional notes: code first vs. use additional depending on causal condition Sequencing issues Sequencing issues Change code title to “Secondary diabetes” Change code title to “Secondary diabetes” Controlled vs. Uncontrolled? Controlled vs. Uncontrolled? Secondary diabetes as late effect? Secondary diabetes as late effect?

Overview of 9/06 Comments Create two new categories similar to ICD- 10-CM Create two new categories similar to ICD- 10-CM 248.x Diabetes due to drug or chemical248.x Diabetes due to drug or chemical 249.x Diabetes due to underlying condition249.x Diabetes due to underlying condition Separate category for diabetes secondary to drug (e.g., steroid use)? Separate category for diabetes secondary to drug (e.g., steroid use)? Surgically-induced secondary diabetes? Surgically-induced secondary diabetes?

Options One code (251.6, Secondary diabetes) One code (251.6, Secondary diabetes) One new category (249, Secondary diabetes) One new category (249, Secondary diabetes) Two new categories (248 & 249) Two new categories (248 & 249) Other options?????? Other options?????? Do nothing????? Do nothing?????