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A patient is admitted for management of his hyperosmolar, nonketotic state due to steroid-induced diabetes mellitus, which he acquired due to long-term use of corticosteroids. He discontinued the steroids several years ago, but he continues to have problems. His diabetes is managed with insulin, but his blood sugar levels have continued to climb. Family members were concerned and brought him to the ED. He is admitted with diabetic hyperosmolar state.

What is the coding and sequencing for this case?

A. E09.00, T38.0X5S, Z79.4
B. T38.0X5A, E09.00, Z79.4
C. T38.3X1S, Z79.4
D. E87.0, T38.3X1A

1 Answer

4 votes

Final answer:

The correct ICD codes for a patient admitted with a diabetic hyperosmolar state due to steroid-induced diabetes mellitus are E09.00, T38.0X5S, and Z79.4, which should be sequenced in that order.

Step-by-step explanation:

The coding and sequencing for a patient admitted with a diabetic hyperosmolar state due to steroid-induced diabetes mellitus, which is being managed with insulin, is critical for proper medical documentation and billing. The International Classification of Diseases (ICD) codes would be utilized in this scenario. Given the information, the patient's primary issue is the hyperosmolar state (hyperglycemia), without mention of ketoacidosis, due to the steroid-induced diabetes mellitus. This specific situation is coded as diabetic hyperosmolar state without ketosis, which is represented by the ICD code E09.00. It indicates drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (HHS). The T38.0X5S code would represent a complication due to the systemic use of corticosteroids affecting the endocrine system, sequela. Finally, Z79.4 indicates that the patient is on long-term (current) insulin use.

Answer A, which includes the codes E09.00, T38.0X5S, and Z79.4, is the correct sequencing for this case. The code E09.00 correctly sets the hyperosmolar state as the primary diagnosis, while T38.0X5S and Z79.4 indicate secondary conditions or factors influencing the patient's diabetic condition.

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