Volume 5, Issue 9

Diabetes mellitus with neurological complications

Symptoms typically affect one side of the body and include and shrinking of the thigh muscles, sharp in the hip and buttock area and weight loss.

Diabetic mononeuropathy is characterized by damage to a specific . Depending on the affected nerve, symptoms may include in the foot, thigh or chest or possibly double vision, trouble focusing and unilateral mellitus is a disorder that affects how the body facial paralysis. processes and uses sugar. When diabetes is not adequately controlled, it can lead to excess sugar in the Treatment blood. Having higher than normal sugar levels can cause There is no cure for . The aim of damage to major organs, including the , , eyes, treatment is slowing the progression of the . and kidneys. It can also damage the tiny vessels that Treatment includes keeping control of blood sugar levels supply blood to the , resulting in diabetic with routine monitoring and blood tests, as well as neuropathy.1 relieving pain symptoms with and working to restore normal function to affected organs. According to the National Institutes of (NIH), Coding guidance diabetic neuropathy is the most common diabetic ICD-10-CM chapter four contains combination codes for , occurring in approximately 50% of all diabetic complications.3 The code set for neurological diabetics over the course of their lifetime.2 complications contains specific details regarding the type Types and symptoms of neuropathy. Medical record documentation must Depending on the nerves or nerve roots involved, diabetes include the same level of detail in order to code to the can cause mononeuropathy, , autonomic highest level of specificity. neuropathy or amyotrophy. It is possible to have more mellitus with neurological complications than one type of neuropathy and the symptoms will vary, E11.40 Neuropathy, unspecified depending upon the type. E11.41 Mononeuropathy Peripheral polyneuropathy is the most common type and E11.42 Polyneuropathy affects the feet and legs first, followed by the hands and E11.43 Autonomic (poly)neuropathy arms. Symptoms include numbness and tingling, sharp E11.44 Amyoptrophy E11.49 Other neurological complication pains, increased sensitivity to touch and loss of balance and reflexes. Resources 1 Mayo Clinic website, Diabetic Neuropathy (accessed August can affect major organs such as 2020): https://www.mayoclinic.org the heart, stomach, bladder and intestines. There is a wide 2 National Institutes of Health (2016): Updates in Diabetic range of symptoms including bladder and bowel problems, (accessed August 2020): https://www.nih.gov , and difficulty controlling body temperature, 3 Optum360° (2019), ICD-10-CM Expert for Physicians, The trouble swallowing and sexual dysfunctions. complete official code set. Diabetic amyotrophy, also known as radiculoplexus neuropathy, is more common among type 2 diabetics.

Reference the ICD-10-CM Codebook, CMS-HCC Risk Adjustment Model(s) and AHA Coding Clinic for complete code sets and official coding guidance. Coverage provided by Amerigroup Inc. AGPCARE-0551-20 November 2020 Y0114_18_36891_I_09/05/2018