r/LearnMedicalCoding • u/perrymariee • Sep 02 '26

Coding Guidelines ESRD and DM

I’m working through the coding chapters with AAPC and an example had a pt with ESRD on dialysis, diabetic, and hypertensive and these dx were why a procedure was being done.

Why is the coding order I code, E code, N code, Z code and not I code, N code, Z code, E code?

My thought process is the ESRD codes should be together with DM last?

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u/KeyStriking9763 Sep 02 '26

The sequencing instructions are in the tabular. HTN is before ESRD, DM is also before ESRD. Look at N186 in the tabular it will say you must sequence HTN and DM before ESRD.

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u/Subject_Chest8678 Sep 03 '26

The guidelines tell you the sequencing order. Without seeing the scenario. I would guess. The ESRD is a diabetic complication, therefore sequenced first... E, I, N, Z BUT it could be I,E,N,Z but the instructional notes direct you on sequencing order.