Diabetes is a chronic condition that demands routine management and is often complicated by common illnesses like respiratory infections or gastrointestinal flu. To ensure appropriate payment from Medicare and commercial insurers, family practice coders must understand the intricacies of diagnosis for accurate diabetes coding, along with the guidelines governing diabetes education reimbursement, and factors that determine which E/M codes should be assigned for routine care.The most important fact about diabetes diagnoses that goes without exception – the requirement of a fifth digit. Most diabetes -related diagnoses may be found in the diabetes mellitus section of the ICD-9 manual. Exceptions include gestational diabetes and neonatal diabetes mellitus. Various classifications and complications are identified with the fourth digit. In addition, coders must add a fifth digit that identifies Type I or Type II diabetes and further indicates if the disease is controlled or uncontrolled. A lot of times, this information isn’t clearly noted on the encounter form. You’ll need to seek out the physician and pinpoint the specific information necessary to determine which ICD-9 code to assign. Diabetes coding is complicated until laboratory results confirming the diagnosis have been received. For instance, a patient may come in with symptoms that strongly suggest diabetes – dizziness, excessive thirst, frequent urination and a family history of the disease. These symptoms will trigger testing for diabetes.” Coders would assign the appropriate E/M code ( 99211-99214, office or other outpatient visit, established patient), along with glucose finger stick code 82962 (glucose, blood by glucose monitoring devices cleared by the FDA specifically for home use) or 82948 (glucose; blood, reagent strip), depending on the method the physician uses. Practices would report a code for urinalysis if one is done at that time. Your diabetes coding will be most accurate when you use these codes to describe the symptoms that would be linked to support medical necessity.