Oncology & Hematology Coding Alert

Watch out for fifth digit changes, though.

In 2005, ICD-9 expanded your dehydration coding options, requiring you to analyze your documentation so you could choose correctly among three different codes. If you've worked hard to be sure documentation includes the information you need, you'll be glad to know that ICD-10 keeps the exact same code definitions.

ICD-9 coding rules: Under ICD-9, you report 276.51 (Dehydration) for depletion of total body water. Blood volume may be normal when the diagnosis is "dehydration." Code 276.52 (Hypovolemia) is appropriate for depletion of blood volume. If the oncologist does not specify dehydration or hypovolemia, you should choose 276.50 (Volume depletion, unspecified).

ICD-10 changes: The relevant ICD-10 codes correspond one-to-one to the ICD-9 codes. The only real difference is the order of the codes. For example, under ICD-9, the unspecified code is first in the range and ends in a "0." Under ICD-10, the unspecified code ends in "9."

Coder tips: In both ICD-9 and ICD-10, the code for "hypovolemia" has a note telling you the code is appropriate for "depletion of volume of plasma."

Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.