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Coding Scenario: Chemotherapy-induced thrombocytopenia

A 71-year-old man is being actively treated for acute monocytic leukemia (AML). He has developed thrombocytopenia as a result of the chemotherapy to treat the AML and is admitted to home health for management of the condition.

 Primary and Secondary Diagnoses  Code
 M1021a: Other secondary thrombocytopenia  D69.59
 M1023b: Adverse effect of antineoplastic and immunosuppressive drug, subsequent encounter  T45.1x5D
 M1023c: Acute monoblastic/monocytic leukemia, not having achieved remission  C93.00

 

Rationale:

  • Code drug-induced thrombocytopenia with D69.59, according to the alphabetic index. Capture that it is an adverse effect of his chemotherapy treatment by also coding T45.1x5D.
  • Code the thrombocytopenia before the T code for the drug because it is an adverse effect and not a poisoning, in accordance with coding guidelines.
  • The correct code for the leukemia is C93.00, since the patient is undergoing active treatment for AML and remission has not been achieved.