# V58. 2 Blood transfusion, w/o reported Dx



## Tonyj (Dec 9, 2011)

Is there an ICD9 code for blood transfusion with reported diagnosis? I have pt's coming in for blood transfusion due to their chemotherapy treatment but I don't have a V code to append. I would guess that blood transfusions are potentially high risk treatment. Any ideas would be appreciated.


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## TonyaMichelle (Dec 9, 2011)

Patients who get chemotherapy usually becomes anemic. The anemia can make them feel weak. The physicians usually orders blood transfusion for the anemia after which the patient would most likely have a well sense of being which this would probably be in the category of palliative care. So, I am thinking that you may use code:

V66.2 (Convalescence and palliative care following chemotherapy)


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## Tonyj (Dec 9, 2011)

Thanks much. Don't know if that really fits a V code for blood transfusion though. I was looking more on the lines of V58.6X


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## sharevans (Dec 9, 2011)

Why was the blood transfusion ordered?  I would use the diagnois as to why the patient is receiving the blood transfusion, to support medical necessity for the transfusion.


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## kevbshields (Dec 30, 2011)

Exactly.  This is a record integrity and documentation improvement issue more than a coding issue.  Orders must state why the service is being performed.  Additionally, providers should provide the clear medical necessity for those services they perform or request.  

First off, ensure that your provider orders (even if from outside your organization) meet the minimal qualifications of complete:  legible, include clear medical necessity (dx or reason), referring provider name, and dates, times and appropriate signatures.

Secondly, do not hesitate to kick back orders that are incomplete or inappropriate.  If they are from your internal providers, ensure that education is going on with those folks.

Lastly, educate on any denials or problematic claims and go back to the order or patient record to demonstrate to the providers why the problems arise.  In this way you are completing the circle and those denied claims don't go to total waste.

Clinically, these patients are probably anemic.  However, it's coaxing this out of the providers that is key to coding these properly and in sufficient detail and finally submitting them for payment.  Hopefully this will help some.


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## mitchellde (Dec 30, 2011)

Kevin is correct and if it is anemia due to the chemo then it needs to be coded as an adverse effect of the chemo using E codes as well.  They must be a reason for the blood transfusion since it is not routine for every patient that receives chemo to also get a blood transfusion, and as Kevin correctly states this must be documented.


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## Tonyj (Jan 3, 2012)

Thanks for all of your inputs. I'm in total agreement.


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