# Coding E933.1 for ICD 10



## bunkie717 (Oct 6, 2015)

In chemotherapy we use E933.1.  I am trying to figure out whether we would use T45.1X5S or T45.1X5D when a patient receiveds Neupogen/Neulasta after chemotherapy.  All of the crosswalks and mapping state T45.1X5S.  Can anyone be of assistance please.


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## dtricia (Oct 6, 2015)

*Sequela vs Subsequent*

A subsequent encounter is an encounter after the patient has receieved active treatment of the injury and is receiving routine care during the healing or recovery phase. Examples are: cast change or removal, medication adjust,emt, other aftercare and follwup visits following injury treatment.

Sequela 'S' is used for complications or conditions that the late effects of an injury, such as a scar or chronic pain. The patient isn't seeking intervention for the initial injury, but for the condition that arises as a result of the injury. 

There is an article  by Miss D Mitchell on this subject in April 2014 AAPC magazine.


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## mitchellde (Oct 6, 2015)

If the provider indicates the neutropenia is due to the chemo and you are actively treating this with the neupstairs then you would use the A as your 7th character as the adverse reaction is being actively treated


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## bunkie717 (Oct 8, 2015)

We give multiple injections for the neutropenia.  So are you saying that each time to bill T45.1x5A???


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## mitchellde (Oct 8, 2015)

If the neutropenia is caused by the chemo then yes each time.


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