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

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

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

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

6. Thyroid
Secretion of hormones regulate
Growth
Metabolism

7. 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

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

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

10. 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

11. 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

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

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