Oncology & Hematology Coding Alert

Question: When a patient presents for treatment of dehydration caused by therapy, should I report the dehydration or the neoplasm first?

Nevada Subscriber


Answer: When you only treat the patient's dehydration and use intravenous dehydration, report the dehydration first, and then report the malignancy, according to Chapter 2: Neoplasms of the ICD-9 Official Guidelines (www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdguide06.pdf).

Example: A patient presents suffering from dehydration following therapy for acute myelogenous leukemia. First report dehydration with the appropriate code (such as 276.51, Volume depletion; dehydration), then report the leukemia (205.00, Myeloid leukemia; acute; without mention of remission).

Watch for: If the patient presents for therapy and then develops dehydration due to complications while still in the office, report the V code for the therapy first (such as V58.11, Encounter for antineoplastic chemotherapy) followed by the code for the neoplasm and the code(s) for any complication (such as 787.01, Nausea with vomiting and dehydration code 276.51).