# ICD-10 Neoplasm guidelines



## shruthi (Mar 26, 2015)

As per ICD-10 general guidelines of chapter 2 for Neoplasm,
*Anemia associated with malignancy states* - when admission/encounter is for management of an anemia associated with the malignancy, and the treatment is only for anemia, appropriate code for malignancy is sequenced as principal or first listed Dx followed by appropriate code for the anemia.

But if we look at ICD-9 guidelines, it is vice versa. *Which states Anemia code should be sequenced first followed by appropriate code for malignancy.*

Why is this difference in the guidelines? As per my understanding, Anemia should be sequenced first because treatment is directed towards anemia and not neoplasm.

Thoughts please.

Regards,
Shruthi


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## mitchellde (Mar 26, 2015)

Some of the guidelines changed for ICD-10 CM.  Look at urosepsis as well.  It is just one of the differences.  While most of the guidelines stated exactly the same a few did change, perhaps it is just an update in thought process along with a code set update.


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## BenCrocker (Mar 26, 2015)

Well Malignant Neoplasms are a bit more serious and are the cause of the manifestation of the Anemia in that case.  Causes are coded before manifestations in I-10 I do believe.


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## shruthi (Mar 27, 2015)

Thanks Debra and Ben for sharing your thoughts.

But when the admission/encounter is for management of an anemia associated with an adverse effect of the administration of chemotherapy or immunotherapy and the only treatment is for the anemia, the anemia code is sequenced first followed by the appropriate codes for the neoplasm and the adverse effect.

This guidelines contradicts with earlier said guidelines for Anemia associated with malignancy.

Regards,
Shruthi.


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## mitchellde (Mar 27, 2015)

Anemia due to the chemo is different than anemia in neoplasm.  One is due to the drug and the other is due to the disease.  You must be careful and not read into the documentation.  The provider must be specific as to the cause of the anemia.  Also it will be different anemia codes.
 D64.81 Anemia due to antineoplastic chemotherapy
 D63.0 Anemia in neoplastic disease


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