Oncology & Hematology Coding Alert

Start thinking in terms of 'agranulocytosis.'

Once ICD-10-CM replaces ICD-9-CM in 2014, not only will you have more options to report neutropenia, but you'll also need to be ready to report every character of adverse effect code T45.1X5-. Here are the details.

ICD-9-CM Code

• 288.03, Drug induced neutropenia

ICD-10-CM Codes

• D70.1, Agranulocytosis secondary to cancer chemotherapy
• 70.2, Other drug-induced agranulocytosis

Diagnosis: Drug-induced neutropenia refers to an abnormally low count of neutrophils (white blood cells) caused by a drug the patient is taking. Agranulocytosis refers to a severe type of neutropenia.

ICD-9-CM coding rules: An instruction with 288.03 indicates you should use an additional E code to identify the drug that resulted in neutropenia. You also should use an additional code for any associated fever (780.61) or mucositis (478.11, 528.00-528.09, 538, or 616.81). Code 288.03 is appropriate for documentation of decreased absolute neutrophil count (ANC), but ICD-9-CM lists three diagnoses that are excluded from 288.03: neutropenic splenomegaly (289.53), transitory neonatal neutropenia (776.7), and leukemia (204.0-208.9).