ICD 10 Coding Alert

Question: I'm coding for a patient with ITP, neutropenia, and macrocytic anemia. The physician addressed these during the office visit, including reviewing lab work and medications. Which ICD-9 codes apply to these diagnoses?

Arizona Subscriber

Answer: Consider the following codes for your case.

ITP: ITP is an abbreviation often used for idiopathic thrombocytopenic purpura. Choose 287.31 (Immune thrombocytopenic purpura) for this diagnosis. The illness involves very low platelet counts. Because platelets function to achieve clotting, patients may have bruising (ecchymoses) and hemorrhaging. (The ICD-10-CM equivalent is D69.3, Immune thrombocytopenic purpura.)

Neutropenia: If the only information you have is "neutropenia," report 288.00 (Neutropenia, unspecified). ICD-9-CM includes several other possible codes, however, so check your documentation against the various 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 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.)