Oncology & Hematology Coding Alert

Hanging on to ICD-10-CM 2010 official guidelines will lead your anemia/neoplasm coding astray.

Anemia coders who got a head start on ICD-10-CM preparation know that the 2010 official guidelines for the new code set differed from ICD-9-CM guidelines regarding code order for anemia and neoplasm in patients with both conditions.

Warning: Those 2010 ICD-10-CM guidelines are out of date. As you continue your preparations, be sure to incorporate the 2013 guidelines below, and make plans to check the guidelines again before the new code set is implemented Oct. 1, 2014. (Guidelines are subject to change, and you should use the guidelines that apply to the date of service.)

Swap Neoplasm and Neoplastic Anemia Code Order

Scenario 1: Suppose a patient presents for treatment of anemia associated with a malignancy (with no treatment of the malignancy at that encounter). Under ICD-9-CM, you report the anemia followed by the malignancy. In contrast, under both 2010 and 2013 ICD-10-CM guidelines, you report the malignancy followed by the anemia.

Add ICD-10-CM Adverse Effect Code for This Anemia

Scenario 2: Suppose a patient presents for treatment of anemia associated with chemotherapy, immunotherapy, or radiotherapy (with no treatment of the malignancy at that encounter). This scenario is where you’ll see the difference between the ICD-10-CM 2010 and 2013 guidelines.

Resource: You may download ICD-9-CM guidelines from www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm#guidelines. The ICD-9-CM official guidelines referenced here became effective Oct. 1, 2011. The guidelines have not been updated since that time because of the code freeze intended to aid in the ICD-10-CM transition. ICD-10-CM guidelines are available at www.cdc.gov/nchs/icd/icd10cm.htm#10update. There are additional guidelines relating to anemia coding and neoplasm coding, so read the complete guidelines to get the full picture.