A patient presented to the hospital with severe fatigue. Complete blood count (CBC) showed low platelets, red and white blood cells. Further workup included bone marrow biopsy that revealed acute myelogenous leukemia. The provider’s final diagnostic statement listed “Pancytopenia due to acute myelogenous leukemia (AML)”. Is the pancytopenia coded in addition to the AML, or is it considered inherent to the AML and therefore not coded separately?
The ICD-10-CM classification does not prohibit assigning code D61.818, Other pancytopenia, along with a code from category C92, Myeloid leukemia. Pancytopenia is not inherent in AML, and therefore both conditions are coded when they meet reporting requirements. In AML, white blood cell counts may be elevated or reduced, and not all patients will have low red blood cell or platelet counts.
AML is a malignant disease of the bone marrow in which the production of normal blood cells decreases, resulting in various degrees of anemia, thrombocytopenia, and neutropenia. Pancytopenia is very common in certain types of AML, and it can be of prognostic importance.