Anemia Coding

Guidelines:

CKD:

When the patient has anemia due to chronic kidney disease (CKD) you must report a code from N18 (CKD) in addition to D63.1 (Anemia in chronic kidney disease). Codes from N18- indicate the stage of the illness

Example:

Patient presented for treatment of stage 3 CKD. The provider also addresses the CKD caused anemia during the encounter. You should report N18.3 – CKD stage 3 – moderate followed by D63.1 for the anemia.

Neoplastic Disease:

In cases where the patient has anemia due to a neoplasm, you should report the proper neoplasm code alongside D63.0 (Anemia in neoplastic disease) However if a patient has anemia caused by his chemotherapy, immunotherapy, or radiotherapy and he presents for the treatment of the anemia only your first listed code should be an adverse effect code. Then report the anemia and neoplasm codes.

Drug Induced Anemias:

Autoimmune hemolytic anemia is caused by auto antibody induced hemolysis. It is usually idiopathic but can be associated with infection, lymphoproliferative disorders, autoimmune diseases and some drugs.

Category D59 contains codes used to report the different types of hemolytic anemias. D59.0 (Drug induced autoimmune hemolytic anemia) and D59.1 (Other autoimmune hemolytic anemia) codes require an additional code to identify the drug. Select a code from T36-T50 with 5^th or 6^th character 5.

Focus on the sequencing of the principal diagnosis (PDX) when patients present with anemia (Chapter 3 in ICD-10). Anemia is the most common disorder of the blood and it affects about a quarter of the population in the world.

Here are a few examples:

· Patient is admitted with anemia due to chronic kidney disease (CKD) or end stage renal disease (ESRD). CKD/ESRD would be the appropriate PDX selection even when treatment is directed towards the anemia only. Per the instructional notes in ICD-10-CM, code first the underlying cause. The manifestation code would not be appropriate as the PDX.

Patient is admitted with anemia due to underlying malignancy. The site of the malignancy would be the appropriate PDX selection even when treatment is directed towards the anemia only. Per the instructional notes in ICD-10-CM, code first the neoplasm. When reading the documentation in the record coders should look for documentation to see if this is anemia of the malignancy or if this is due to the treatment of the malignancy (surgical blood loss anemia or drug induced anemia). If not due to the malignancy but due to the treatment of the malignancy then anemia may be appropriate as the PDX.

Patient is admitted with anemia and malignancy. The physician documents that the anemia is due to the anti-neoplastic drugs that the patient has been taking. In this case, the anemia due to antineoplastic chemotherapy would be sequenced as the PDX and not the malignancy (if the treatment is only directed at the anemia).

· Patient is admitted with anemia due to rheumatoid arthritis and lupus. Treatment is directed at correcting the anemia. The underlying chronic condition of rheumatoid or lupus would be the appropriate PDX selection. Per the instructional notes in ICD-10-CM, code first the underlying chronic condition.

Below are a few definitions of anemia and the types associated with chronic diseases/malignancy. Please keep in mind, this is a very small selection of types of anemia (there are over 400 types but can be divided into three groups…anemia caused by blood loss, anemia caused by decreased or faulty red blood cell production, and anemia caused by destruction of red blood cells).

Anemia—decrease in the amount of RBCs or hemoglobin in the blood

Anemia of Chronic Disease (or of chronic inflammation)—This type of anemia is associated with many underlying chronic disorders including cancer, infections, autoimmune disease, inflammatory diseases or kidney disease being the most common culprits.

Anemia due to Chemotherapy—very common side effect of use of chemotherapy drugs treating malignancy. Chemotherapy reduces the bone marrow’s ability to make red blood cells.

Sickle–cell trait (SCT) refers to a type of sickle–cell disorder (SCD) that leads to formation of hard, sticky, and sickle–shaped (C–shaped) red blood cells (RBCs) and decreased number of red cells compared to normal, causing anemia. A patient with SCT receives one sickle cell gene (S) from one parent and one normal gene (A) from another parent.

Aplastic Anemia—your marrow stops making new blood cells (red, white, and platelets). The bone marrow stops producing enough new blood cells. The patient is deficient of red blood cells, white blood cells and platelets. Not a single disease but a group of closely related disorders characterized by failure of the bone marrow to produce all three types of blood cells (red, white, and platelets). This is a very rare disorder and only affects about 1,000 people each year in the US.

Comments

Revenue Cycle Management - RCM

When you enter the field of US Healthcare, the first thing you notice right away is the unique terminology that keeps bombarding you! New medical terms and medical slang keep popping up. Added to it is the abbreviations, acronyms and what not.... You feel overwhelmed at first... But gradually with some patience you can master the terms which are used often in your office. I am listing below some common healthcare terms used in Insurance and Billing in RCM. Check them out and hope you will learn a word or two! BILLING TERMS When both you and your health insurance company pay for your health care expenses, it’s called cost sharing. Deductibles, coinsurance and copays are all examples of cost sharing. Understanding how they work will help you know how much you’ll pay. Deductible A deductible is the amount you pay for health care services before your health insurance begins to pay. How it works: If your plan’s deductible is $1,500, you’ll pay 100 percen...

What is Medical Coding?

Medical coding is the transformation of healthcare diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes.” Put simply, this refers to the process of translating important medical information into simple codes for the purpose of documenting medical records and informing accurate medical billing. There are a few different types of medical codes used in healthcare settings today, but each of them allows for uniform documentation between medical facilities. Having this standard system allows for a more seamless transfer of medical records and more efficient research and analysis to track health trends. The three main types of codes are ICD-10-CM, CPT-4, and HCPCS What is a medical coder? Medical coders are the individuals responsible for translating physicians’ reports into useful medical codes. These professionals work behind the scenes in a variety of settings, ensuring all pertinent information is coded appropria...

CPT Quiz - 40000 Series

Quiz created by Vijayarani Sivakumar with GoConqr

Allograft vs Autograft vs Xenograft

Allo – Same species Auto – Same person Xeno – Animal (different species) An autologous transplant uses a person's own stem cells. ... In a reduced-intensity allogeneic transplant, doctors suppress the recipient's immune system enough so the donor stem cells can take root, or “engraft,” there. An autograft is a bone or tissue that is taken from a part of a person’s own body and transplanted into another. Often, surgeons will use a person’s own hamstring tendon to repair a damaged anterior cruciate ligament. Similarly, an autograft bone may be transplanted from a person’s hip to aide in a spinal fusion. Patients who undergo autograft procedures may experience increased postoperative pain from the second surgical (autograft) site. They may also require longer periods of rehabilitation. The use of allograft is advantageous because there is no second procedure required to remove and transfer a portion of the patient’s native bone or tissue. Surgical time may be...

Anatomy & Physiology Quiz

Quiz created by Vijayarani Sivakumar with GoConqr

Necessity of English Proficiency in Medical Coding

Irish Blessing A moonbeam to charm you, A sheltering angel, so nothing can harm you. A sunbeam to warm you, Naturally, being fluent in English places you at an advantage in the field of Medical Coding. That being said, it does not fully eliminate you from entering Coding. Medical Coding is different from Medical Transcription and does not require the same expertise and fluency in English. Medical Transcription careers demand that you be highly fluent in American English, as we get most of our clients from the USA. You need to be tuned to their culture and lifestyle to name a few. But that is not the case with coding. Of course you should have a working knowledge of English. Or else you will be unable to comprehend a Medical Chart. As you need to peruse a medical chart, understand what is being done for a patient and derive the codes. The requirement for fluency in English is not as high as in Transcription. I keep comparing the two fields of transcription and coding becaus...

Spleen - Anatomy

The spleen is an organ located in the upper left abdomen, and is roughly the size of a clenched fist. In the adult, the spleen functions mainly as a blood filter, removing old red blood cells. It also plays a role in both cell-mediated and humoral immune responses. The spleen in located in the upper left quadrant of the abdomen, under cover of the diaphragm and the ribcage – and therefore cannot normally be palpated on clinical examination (except when enlarged). It is an intraperitoneal organ, entirely surrounded by peritoneum (except at the splenic hilum). The spleen is connected to the stomach and kidney by parts of the greater omentum – a double fold of peritoneum that originates from the stomach: The spleen has a slightly oval shape. It is covered by a weak capsule that protects the organ whilst allowing it to expand in size. The outer surface of the spleen can be anatomically divided into two: · ...

US Healthcare - Payment Posting

Payment posting and denial management are two extremely critical steps of the revenue cycle management of any solo practitioner or a healthcare organization. Streamlining these processes improves the RCM cycle leading to lesser delays in the A/R’s, ultimately guiding the way to increasing revenues along with patient satisfaction. Payment posting and its factors: In this process, the payment records of patients are recorded in the billing management software. It also includes attention to be given to claim denials — for identifying the problematic areas and their reasons along with apt actions to be taken on resolving the issues. Insurance Payment Posting: All payers either send an EOB (explanation of benefits) or ERA (electronic remittance advice) towards the payment of a claim. The medical billing staff posts these payments immediately into the respective patient accounts, against that particular claim to reconcile them. The payment posting is handled according to clie...

Medical Coding, an excellent career choice!

As we are reeling under the pressure of COVID-19 infection in India, unemployment has reached sky high. Many have tried binge eating, binge cooking and binge watching movies to ward off boredom. So what is an alternative and viable option for our youngsters? Why not try something useful, that will enhance your career, or give a boost to your existing career. Learn something online. Be it a new skill, a new language, or something trending like Medical Coding. Medical Coding is a boon in such testing times. You can learn Medical Coding and re-skill yourself and reshape your career. If you are a graduate looking for an interesting and engrossing profession, Medical Coding checks all the boxes. The basic criteria needed is a college degree. Being tech savvy, which most of the youngsters are already thanks to smart phones, will help you move into this profession quite smoothly. A working knowledge of English is a must, as we receive all the work from USA. Once y...

Dwindling Medical Transcription

Mayo Cuts Medical Transcriptionists The Mayo Clinic recently gave 400 medical transcriptionists the option of a “voluntary separation package” or pursue another job, according to the Rochester, Minn. Post-Bulletin . A new electronic health record (EHR) system is forcing the cuts. The healthcare system, which has facilities in Minnesota, Wisconsin, Arizona, Florida, and other states employs the transcriptionists in several places where most of them transcribe medical notes recorded by providers at home. EHR Taking Over “This is part of a national trend in health care. New tools are reducing the need for transcription services. As a result, the need for medical transcriptionists to convert dictation into written reports is also declining,” said Roshy Didehban, chair of practice administration at Mayo Clinic, told the Post-Bulletin . “We’ve had honest, ongoing conversations with our staff about this change and are taking steps to help red...

Medical Coding Simplified

Search This Blog