Oncology & Hematology Coding Alert

Question: In a patient who was reported to have venous thrombosis, our physician has documented a diagnosis of heparin induced thrombocytopenia. Do we request our physician confirm the diagnosis? How do we report the thrombosis?

Michigan Subscriber

Answer: Your physician may be correct to diagnose heparin induced thrombocytopenia in a patient who develops venous thrombosis. Check the documentation, and make sure the use of heparin is mentioned clearly.

Pick up a specific code: ICD-9 offers a specific code for this condition. You report code 289.84 (Heparin-induced thrombocytopenia [HIT]) for thrombocytopenia induced by heparin administration. This specific ICD-9 code maps to code D75.82 (Heparin-induced thrombocytopenia [HIT]) in ICD-10.

What is Heparin induced thrombocytopenia? Heparin induced thrombocytopenia is a distinct clinical entity. It is a relatively common life-threatening clinical condition that occurs in 3-5% of all patients receiving unfractionated heparin for at least 5 days. Heparin induced thrombocytopenia has a distinct clinical presentation that is different from other drug-induced thrombocytopenias. Patients may present with arterial or venous thrombosis, such as deep vein thrombosis, pulmonary embolism, stroke, or myocardial infarction.

Note: Transfusion of platelets is generally contraindicated in heparin induced thrombocytopenia. Your physician will switch the patient to an alternative anticoagulant.