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Oncology & Hematology Coding Alert

Reader Questions:

Lowdown on New Fifth-Digit Classifications

Published on Mon Mar 23, 2009

Question: Some oncology diagnosis codes for 2009 include changes to the fifth-digit classifications of no mention of remission, relapse, and remission. What are the differences? Nebraska Subscriber Answer: This fifth-digit change primarily applies to lymphatic neoplasms (and leukemias). The American Academy of Pediatrics (AAP) proposed the new sub-classifications to allow a separate classification for lymphatic neoplasms in relapse and to further distinguish the fifth-digit choices from one another. The change: Previous editions of ICD-9 listed two choices for a fifth-digit classification among lymphatic neoplasms: 0 (without mention of remission) and 1 (in remission). ICD-9 2009 modifies and expands the classifications: 0 (without mention of having achieved remission [failed remission]), 1 (in remission), and 2 (in relapse). Call on "0": Use the fifth digit of "0" when you are treating the primary disease not in remission; when you are treating the initial phase of the disease (the initial or first treatment); [...]
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