Home Health ICD-9/ICD-10 Alert

Question: I read an article that said ICD-10 guidelines for anemia/neoplasm coding differ from ICD-9. Where can I access the ICD-10 guidelines?

Iowa Subscriber

Answer: You can download the 2010 ICD-10 guidelines from CMS's ICD-10 site: www.cms.gov/ICD10/12_2010_ICD_10_CM.asp. You also can download them from the CDC's ICD-10-CM site: www.cdc.gov/nchs/icd/icd10cm.htm#10update.

ICD-9: ICD-9 guidelines state that your first-listed code should be for anemia, 285.22 (Anemia in neoplastic disease). Then, the guidelines instruct you to report the appropriate malignancy code(s).

ICD-10: ICD-10 guidelines, on the other hand, instruct you that in the above scenario, you must report the malignancy first and then the anemia code, D63.0 (Anemia in neoplastic disease).

ICD-9: You should sequence the anemia first (such as 284.89, Aplastic anemia due to drugs), according to ICD-9 guidelines. When the patient has an adverse reaction to a correctly prescribed and administered substance, ICD-9 instructs you to code the reaction followed by a code from E930-E949. For example, you might report E933.1 (Drugs, medicinal, and biological substances causing adverse effects in therapeutic use; antineoplastic and immunosuppressive drugs). Then report the appropriate neoplasm code.

ICD-10: 2012 ICD-10 guidelines are much like the ICD-9-CM guidelines. Report the anemia, then the adverse effect code and then the neoplasm. Example: Your patient has aplastic anemia from chemotherapy and has multiple myeloma. Report the anemia, the adverse effect code then the neoplasm code.

• M1020: D61.1 (Drug induced aplastic anemia);
• M1022: T45.1x5S (Adverse effect of antineoplastic and immunosuppressive drugs); and
• M1022: C90.00 (Multiple myeloma not having achieved remission).