Question

Read ICD-10-CM Coding Guideline: (L.C.2.c.1) Anemia associated with malignancy before trying to code these scenarios. Based on the above guidelines how will you code the following scenarios? Provide all correct diagnosis codes for each of the scenarios incorrect order of sequencing Scenario 1: This 62-year-old female with malignant neoplasm of the pancreatic head with metastasis to the liver was admitted for management of dehydration due to the malignancy. The only treatment received was intravenous rehydration for the dehydration Scenario 2: A 72-year-old female with squamous cell carcinoma of the left lower lobe was admitted for management of anemia associated with the lung carcinoma. The treatment is only for anemia. Scenario 3: This 57-year-old female was admitted for chemotherapy. She is receiving chemotherapy for breast cancer on the right breast, lower-inner quadrant, with metastasis to the right lung. Scenario 4: A patient with known carcinoma of the pancreatic neck is admitted with an Hgb of 9.1. He has been receiving Docetaxel chemotherapy and the physician determines this new anemia as an adverse effect of the chemotherapy. The patient is treated with darbepoetin alpha and TV iron. The patient is discharged with an improvement in Hgb to 11.3. Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E89) Refer to the related chapter specific guidelines and code the Scenarios. With each scenario mention the guideline you followed 5. Patient has type 1 diabetes with hyperglycemia due to mechanical breakdown of an insulin pump, which resulted in underdosing 6. A patient with type 2 diabetes has been undergoing changes to daily insulin dosages. The patient's diabetes is uncontrolled 7. The patient takes daily insulin for diabetes. 8. Patient has type 1 diabetes with hypoglycemia due to mechanical breakdown of an insulin pump, which resulted in overdosing

Answer 1

ANSWER.

ICD-10-CM Coding.

* Scenario 1 codes.

       * E86.0 - Dehydration.

       * C78.7 - Secondary malignant neoplasm of liver and intrahepatic

                      bile duct.

       * C25.0 - malignant neoplasm of the pancreatic head.

* Scenario 2 codes.

       * C34.32 - Malignant neoplasm of the left lobe,left bronchus or lung.

       * D63.0 - Anemia in neoplastic disease.

* Scenario 3 codes.

       * Z51.11 - Encounter for antineoplastic chemotherapy.

       * C78.01 - Secondary malignant neoplasm of right lung.

       * C50.311 - Malignant neoplasm of lower inner quadrant of right female

                          breast.

* Scenario 4 codes.

      * D64.81 - Anemia due to antineoplastic chemotherapy.

      * C25.7 - Malignant neoplasm of neck of pancreas.

Chapter 4.

* Scenario 5

         According to icd-10-guidenine this scenario is coded as

              * First assign code for Mechanical pump failure.

              * Second assign code for under dose.

* Third assign code for type of diabetes mellitus.            

              * Fourth assign code for aasociated complication if present.

    So

        Scenario 5 codes are

              * T85.614A - Mechanical breakdown of insulin pump.

              * T38.3X6A - Underdosing of insulin.

              * E10.65 - Type 1 diabewtes mellitus with hyperglycemia.

* Scenario 6 codes

         According to icd-10- guideline scenario 5 coded as

               * First assign code for type of diabetes mellitus.

               * Second assign the code for long term use of insulin therapy.

    So

      Scenario 6 codes are

                * E11.65 - Type 2 diabetes mellitus with hyperglycemia(Uncontrolled)

                * Z79.4 - Long term(current) use of insulin.

* Scenario 7 codes.

       According to icd-10-cm guideline

          * First assign code for Type of diabetes mellitus

          * Second assign code for daily use of insulin.

       So

          Scenario 7 codes are

              * E11.9 - Type 2 diabetes mellitus without complications.

              * Z79.4 - Long term use of insulin.

* Scenario 8 codes.

        According to icd-10-cm guideline for overdosing of insuiln.

           * First assign the code for mechanical pump failure.

           * Second assign the code for overdose.

           * Third assign the code for type of diabetes mellitus.

    So

       Scenario 8 codes are

            * T85.614A - Mechanical breakdown of insulin pump.

           * T38.3X1A - Poisoning by insulin.

           * E10.649 - Type 1 diabetes mellitus with hypoglycemia without coma.