poorly controlled diabetes

tkreilingtkreiling
in CDI Talk Archive
Does anyone have clinical criteria for poorly controlled diabetes vs uncontrolled diabetes? Our physician has documented poorly controlled diabetes which takes the code to 250.00 but with BS of 496 and HgA1c 12.4 at admit, we are thinking this would be more of uncontrolled diabetes. I would just like to add some clinical indicators on my query with the difference in the 2 terms if anyone has some and would be willing to share?
Thanks,
Tara RN, CCDS

Comments

  • robert.hodges2robert.hodges2
    edited May 2016
    I don't have a "criteria" because to me it's a clinical judgment. I teach my providers a twist on the philosophy of the great Jedi Master Yoda: "It is either controlled or not controlled, there is no other option." So far none have disagreed including the physician who ran our diabetes clinic.



    Robert



    Robert S. Hodges, BSN, MSN, RN, CCDS

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC



    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov



    “Patriotism is easy to understand in America; it means looking out for yourself by looking out for your country" Calvin Coolidge



  • paxnerospaxneros
    Someone on this site posted this information which I use when Querying for Uncontrolled DM:

    "There is an article called diabetes Classification Integral to Hospital Quality Measurement" ACDIS Oct. 6, 2008

    States:

    "The criteria for uncontrolled diabetes is individualized by the treating physician; however a Hgb A1C greather than 7% or multiple blood glucoses greater than 250 mg.dl usually indicate uncontrolled diabetes."

    Thanks,

    Norma T. Brunson, RHIA,CDIP,CCS,CCDS
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited May 2016
    Norma: You criteria you cite for 'uncontrolled DM is that endorsed by our System and vetted by our Senior Endocrinologist. Note that with ICD-10 we no longer will code the DM as controlled or uncontrolled...big change.

    Thanks!

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.637.9002
    Fax:  415.600.1325
    Ofc:  415.600.3739
    evanspx@sutterhealth.org

  • paxnerospaxneros
    edited May 2016
    It may have been posted by you, Paul. I remember getting it from the CDI Talk Group.

    Yes you are correct regarding I-10 & DM. Many things will go by the wayside after I-10.

    NBrunson, RHIA,CDIP,CCS,CCDS




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