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The oxidation of pyruvate via the PDHc is highly exergonic with a free energy change on the order of 33 to 37.5 kJ/mol (8 to 9 kcal/mol)

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When a diabetic patient has CKD, the coder should assign E11.22 (T2DM with CKD) and N18.x without waiting for the provider to write CKD caused by diabetes. The exception: if the provider explicitly states the conditions are unrelated, follow that documentation

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