Pathology/Lab Coding Alert

But coagulation defects exit 'other specified' category.

You can expect some stability in reporting bone marrow/blood diagnoses when you change to ICD-10 on Oct. 1, 2014 -- at least in the "other specified" and "unspecified" codes.

The diagnosis for the case in "3 Tips Substantiate Bone Marrow Case Study Coding" on page 89 is 289.9 (Unspecified diseases of blood and blood-forming organs), which has a direct crosswalk in ICD-10 to D75.9 (Disease of blood and blood-forming organs, unspecified).

Downsize 'Other Specified' Family

Although several entries remain the same for "other specified diseases of blood and blood-forming organs," you can expect some changes, too, when you switch to ICD-10.

The same: Look for a direct cross walk for the following codes:

• 289.83 (Myelofibrosis NOS) crosswalks to D75.81 (Myelofibrosis)
• 289.84 (Heparin-induced thrombocytopenia [hit]) crosswalks to D75.82 (same definition)
• 289.89 (Other specified diseases of blood and blood-forming organs) crosswalks to D75.89 (same definition), although ICD-10 also adds two specific codes for conditions that reports to the "other specified" category in ICD-9, as follows:

D89.2 (Hypergammaglobulinemia, unspecified) 
D47.4 (Osteomyelofibrosis).

The change: Although ICD-9 lists certain coagulation defects in "other specified" category 289.8, ICD-10 moves these codes from "other specified" category as follows:

• 289.81 (Primary hypercoagulable state) crosswalks to:

D68.51 -- Activated protein C resistance
D68.52 -- Prothrombin gene mutation
D68.59 -- Other primary thrombophilia
D68.61 -- Antiphospholipid syndrome
D68.62 -- Lupus anticoagulant syndrome.

• 289.82 (Secondary hypercoagulable state) crosswalks to

D68.69 -- Other thrombophilia.