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Here is exactly what needs to be in the chart for each code type: When to Send a Physician Query Send a formal query when: High HbA1c or diabetes medications appear on record but no formal diabetes diagnosis is documented A specialist note mentions a complication but the treating physician hasnt connected it to the diabetes The type of diabetes is ambiguous (young thin patient on insulin with no Type 2 risk factors) A drug known to cause diabetes is on the medication list but no causal connection has been drawn CKD is documented but the stage is not specified Retinopathy is documented but the eye is not specified Queries must be objective
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This position helps prevent stomach acid from rising into the esophagus
