Oncology & Hematology Coding Alert
Sickle-Cell and Hemolytic Anemia Diagnoses Highlight Your Upcoming Oncology/Hematology Changes
Always report the code with the highest level of specificity, based on documentation. October 1 brings the next round of ICD-10-CM codes to both software and manuals, and if you’re not prepared, your claims could end up in limbo — particularly for hematology coders. In a nutshell: You won’t find any changes to the neoplasm section, but you will see some to the hematology section, says Kristen Taylor, CPC, CHC, CHIAP, associate partner at Pinnacle Enterprise Risk Consulting Services. “In almost all cases, ICD-10-CM converted a code to a parent code and added additional specificity with a fourth or fifth digit.” This year seems to bring the fewest changes to codes that might be reported by oncology practices, but “like it or not, if you fail to take note of them, it could have an impact on establishing medical necessity for testing or management options,” says Melanie Witt, RN, MA, independent coding consultant from Guadalupita, NM. “Keeping abreast of even minor changes can be important to the bottom line and ensures that the most accurate information is being passed on to decision-makers of all types,” she adds. Distinguish Between Sickle Cell Disorders You’ll have 22 new codes specifying new codes providing more detailed options for sickle cell anemia disorders. The new codes account for patients with vaso-occlusive crisis. Hb-SS disease: For instance, you’ll have D57.03 (Hb-SS disease with cerebral vascular involvement) and D57.09 (Hb-SS disease with crisis with other specified complication). Other codes include those for Sickle-cell/Hb-C disease, which are D57.213 (Sickle-cell/Hb-C disease with cerebral vascular involvement) and D57.218 (Sickle-cell/Hb-C disease with crisis with other specified complication). Sickle-cell thalassemia: You’ll also find a bevy of new codes for sickle-cell thalassemia, including additional complications. Some codes within this category have been slightly revised. Your oncologist or hematologist will need to specify the sickle-thalassemia type, but if you don’t know if the patient’s blood cells are beta zero or beta plus, you will use the unspecified classification. Additionally, some of the new diagnoses provide more detail with an option for cerebral vascular involvement and a code indicating the diagnosis assigned was supported by other specified information not inclusive of the category choices: However, if you know the patient’s blood cells are beta zero, then you should choose from the following codes: If the patient’s blood cells are beta plus, then you have a different set of codes to learn: Other sickle-cell disorders: You also have two “other” sickle-cell disorder codes to use, which are D57.813 (Other sickle-cell disorders with cerebral vascular involvement) and D57.818 (Other sickle-cell disorders with crisis with other specified complication). You should always try to report diagnoses with the highest level of specificity, supported by your physician’s medical record documentation. Add These Hemolytic Anemia and Eosinophilia Diagnoses Patients with hemolytic anemias have red cells which are destroyed faster than they are made. You’ll report this condition with new ICD-10-CM codes that will be expanded fro D59.1 (Other autoimmune hemolytic anemias) to include specific types of autoimmune hemolytic anemias. They are: Another disorder dealing with cells is eosinophilia, which is characterized by higher than normal disease-fighting white blood cells. After October 1, you’ll be able to report this condition with new codes specifying eosinophilia as well as hypereosinophilic syndromes: Patient Has Immunodefeciency? Check Out These New Dx With the heightened scrutiny on patients with immunodeficiencies during the COVID-19 pandemic, it’s no surprise you’ll have some new codes in which to report various types. They are:
Oncology & Hematology Coding Alert
- ICD-10-CM Update:
Sickle-Cell and Hemolytic Anemia Diagnoses Highlight Your Upcoming Oncology/Hematology Changes
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