AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 3; Ask the Editor

Neutropenic Fever with Pancytopenia due to Chemotherapy

A patient is admitted with febrile neutropenia and pancytopenia due to chemotherapy. According to Coding Clinic Fourth Quarter 2014, pages 22-23, “Patients may present with both pancytopenia and neutropenia with fever. They are clinically different processes. The pancytopenia code alone does not convey the complete clinical picture.” However, the Excludes1 note at category D61, Other aplastic anemias and other bone marrow failure syndromes, prohibits assigning code D70.1, Agranulocytosis secondary to cancer chemotherapy, along with a pancytopenia code in this category.” The ICD-10-CM Official Guidelines for Coding and Reporting, Section I.A.12.a states, “An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other.” Based on the above information, is it now appropriate to assign codes for pancytopenia due to chemotherapy and neutropenia with fever when the patient presents with both conditions? ...

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