287.3 and More Apply to This Case
Question: You are coding for a patient going through ITP, neutropenia, and macrocytic anemia. The physician addressed these in the office visit, including reviewing lab work and medications. Which ICD-9 codes are applicable to these diagnoses?
Answer: Consider the following codes for your case.
ITP: ITP is an abbreviation frequently used for idiopathic thrombocytopenic purpura. You must choose 287.31 (Immune thrombocytopenic purpura) for this diagnosis. The illness includes very low platelet counts. As platelets function to attain clotting, patients may have bruising (ecchymoses) and hemorrhaging. (The ICD-10-CM equivalent is D69.3,Immune thrombocytopenic purpura.)
Neutropenia: In case the only info you have is "neutropenia," report 288.00 (Neutropenia, unspecified). ICD-9-CM includes a lot of other possible codes, however, so check your documentation against the numerous possibilities in the 288.xx (Diseases of white blood cells) and 289.xx (Other diseases of blood and blood-forming organs) ranges. In neutropenia, the patient has a low neutrophil (white blood cell) count in the circulating blood. (ICD-10-CM includes unspecified option D70.9, Neutropenia, unspecified, in addition to six more specific codes in the D70.-, Neutropenia, range.)
Macrocytic anemia: ICD-9-CM includes macrocytic anemia under the unspecified ICD-9 code 281.9 (Unspecified deficiency anemia). The term macrocytic anemia applies to a variety of syndromes involving larger than normal erythrocytes (red blood cells) in the circulating blood. (ICD-10-CM indexes macrocytic anemia to D53.9, Nutritional anemia, unspecified.)
153.8 Applies When Location Is Undetermined
Question: The oncologist's documentation approves the pathologist's diagnosis of primary malignant neoplasm of the colon. The resection specimen involved a portion of the hepatic flexure and transverse colon, however the pathologist reported he couldn't identify the origin of the cancer. What diagnosis code(s) should you use?
Answer: Report ICD-9 code ( source icd 9 http://www.supercoder.com/icd9-codes/ ) 153.8 (Malignant neoplasm of other specified sites of large intestine) for this case. Colon or colorectal cancer can start in the large intestine (colon) or the rectum (end of the colon).
Even though the resection involves specific sites that have their own cancer, 153.1 (Malignant neoplasm of transverse colon) and 153.0 (Malignant neoplasm of hepatic flexure), you must not choose either of those codes.
Here's why: As documentation does not specify the location of the cancer within the specimen, you can't select one of the more specific codes. Instead, you must use ICD9 codes 153.8. An ICD-9-CM text note demonstrates that the code represents "malignant neoplasm of contiguous or overlapping sites of colon whose point of origin cannot be determined."
Question: You are coding for a patient going through ITP, neutropenia, and macrocytic anemia. The physician addressed these in the office visit, including reviewing lab work and medications. Which ICD-9 codes are applicable to these diagnoses?
Answer: Consider the following codes for your case.
ITP: ITP is an abbreviation frequently used for idiopathic thrombocytopenic purpura. You must choose 287.31 (Immune thrombocytopenic purpura) for this diagnosis. The illness includes very low platelet counts. As platelets function to attain clotting, patients may have bruising (ecchymoses) and hemorrhaging. (The ICD-10-CM equivalent is D69.3,Immune thrombocytopenic purpura.)
Neutropenia: In case the only info you have is "neutropenia," report 288.00 (Neutropenia, unspecified). ICD-9-CM includes a lot of other possible codes, however, so check your documentation against the numerous possibilities in the 288.xx (Diseases of white blood cells) and 289.xx (Other diseases of blood and blood-forming organs) ranges. In neutropenia, the patient has a low neutrophil (white blood cell) count in the circulating blood. (ICD-10-CM includes unspecified option D70.9, Neutropenia, unspecified, in addition to six more specific codes in the D70.-, Neutropenia, range.)
Macrocytic anemia: ICD-9-CM includes macrocytic anemia under the unspecified ICD-9 code 281.9 (Unspecified deficiency anemia). The term macrocytic anemia applies to a variety of syndromes involving larger than normal erythrocytes (red blood cells) in the circulating blood. (ICD-10-CM indexes macrocytic anemia to D53.9, Nutritional anemia, unspecified.)
153.8 Applies When Location Is Undetermined
Question: The oncologist's documentation approves the pathologist's diagnosis of primary malignant neoplasm of the colon. The resection specimen involved a portion of the hepatic flexure and transverse colon, however the pathologist reported he couldn't identify the origin of the cancer. What diagnosis code(s) should you use?
Answer: Report ICD-9 code ( source icd 9 http://www.supercoder.com/icd9-codes/ ) 153.8 (Malignant neoplasm of other specified sites of large intestine) for this case. Colon or colorectal cancer can start in the large intestine (colon) or the rectum (end of the colon).
Even though the resection involves specific sites that have their own cancer, 153.1 (Malignant neoplasm of transverse colon) and 153.0 (Malignant neoplasm of hepatic flexure), you must not choose either of those codes.
Here's why: As documentation does not specify the location of the cancer within the specimen, you can't select one of the more specific codes. Instead, you must use ICD9 codes 153.8. An ICD-9-CM text note demonstrates that the code represents "malignant neoplasm of contiguous or overlapping sites of colon whose point of origin cannot be determined."
