Oncology & Hematology Coding Alert

Question: A patient who is in treatment for lymphoma has developed anemia. The patient presented for weakness and is now under treatment for anemia. How can we report this condition?

Alabama Subscriber

Answer: The anemia in the patient is an adverse event due to the chemotherapy for lymphoma treatment. For this chemotherapy induced anemia, you report ICD-9-CM code 285.3 (Antineoplastic chemotherapy induced anemia). This code corresponds to the ICD-10-CM code D64.81 (Anemia due to antineoplastic chemotherapy). To be specific that the anemia was an adverse event, you will submit ICD-9-CM code E933.1 (Antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use) for the diagnosis of anemia. When ICD-10-CM is effective, you will have to specify if the patient made an initial or sequential visit to the physician for the management of the adverse event (anemia in this case). You will chose from the following two codes in ICD-10-CM:

• T45.1X5A, Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter

• T45.1X5S, Adverse effect of antineoplastic and immunosuppressive drugs, sequela

You can also submit a diagnosis code for lymphoma. In this case, your physician has not specified any details of the lymphoma. Hence, you submit ICD-9-CM code 202.80 (Other malignant lymphomas unspecified site). When ICD-10-CM is implemented, you will choose from a series of corresponding codes: C82.50 (Diffuse follicle center lymphoma, unspecified site) - C86.4 (Blastic NK-cell lymphoma) depending upon the nature and type of lymphoma.