Pathology/Lab Coding Alert

Don’t let name changes confuse you

You’ll have a direct crosswalk for B-cell chronic lymphoid leukemia when you switch from ICD-9 to ICD-10 later this year. But you might have a hard time finding it because the names are slightly different as you can see:

• ICD-9: 204.1 — Lymphoid leukemia chronic includes lymphatic, lymphoblastic, lymphocytic, lymphogenous leukemias
• ICD-10 C91.1 — Chronic lymphocytic leukemia of B-cell type

Categorization Changes

In the past, chronic lymphoid leukemia has been characterized by the stage at which blood cells stopped maturing — immature cells, called lymphoblasts, or mature cells, called lymphocytes. But a more recent classification system focuses on the cell line — B cells, T cells, or NK cells.

You can see the difference between ICD-9, which refers to “lymphoid” leukemia, including lymphoblastic and lymphocytic, among other names, and ICD-10, which refers to “lymphocytic leukemia of B-cell type.”

Remission and Relapse Guide Choice

Both ICD-9 and ICD-10 require a fifth digit for the condition, which depends on whether the leukemia is in remission or relapse.

Here are your ICD-9 choices with their ICD-10 crosswalk counterparts:

• 204.10 — Chronic lymphoid leukemia, without mention of having achieved remission
• C91.10 — Chronic lymphocytic leukemia of B-cell type not having achieved remission 
• 204.11 — Lymphoid leukemia chronic in remission
• C91.11 — Chronic lymphocytic leukemia of B-cell type in remission
• 204.12 — Chronic lymphoid leukemia, in relapse
• C91.12 — Chronic lymphocytic leukemia of B-cell type in relapse