ICD-10 Coding for Pancytopenia Due to Chemotherapy(D61.810)
Complete ICD-10-CM coding and documentation guide for Pancytopenia Due to Chemotherapy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pancytopenia Due to Chemotherapy
D60-D64Primary Range
Aplastic and other anemias and other bone marrow failure syndromes
This range includes codes for pancytopenia, specifically D61.810 for chemotherapy-induced cases.
Key Information: ICD-10 code for pancytopenia due to chemotherapy
Essential facts and insights about Pancytopenia Due to Chemotherapy
Primary ICD-10-CM Code for pancytopenia due to chemotherapy
Decision Criteria
clinical Criteria
- Pancytopenia documented as due to chemotherapy
coding Criteria
- Use T45.1X5A with D61.810 for adverse effect coding
Applicable To
- Pancytopenia due to chemotherapy
Excludes
- Agranulocytosis due to chemotherapy (D70.1)
Clinical Validation Requirements
- Documentation linking pancytopenia to chemotherapy
- Lab results showing low hemoglobin, WBC, and platelets
Code-Specific Risks
- Incorrectly coding as D61.9 when chemotherapy is the cause
Coding Notes
- Ensure documentation specifies chemotherapy as the cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Adverse effect of antineoplastic and immunosuppressive drugs
T45.1X5AAgranulocytosis secondary to cancer chemotherapy
D70.1Fever complicating other conditions
R50.81Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Other drug-induced pancytopenia
D61.811Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pancytopenia Due to Chemotherapy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D61.810.
Impact
Clinical: Misrepresentation of patient condition., Regulatory: Potential audit issues., Financial: Incorrect reimbursement.
Mitigation Strategy
Ensure clear documentation linking pancytopenia to chemotherapy.
Impact
Reimbursement: May result in lower DRG weight and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation specifies chemotherapy as the cause.
Impact
Lack of specificity in linking pancytopenia to chemotherapy.
Mitigation Strategy
Educate providers on documentation requirements.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Pancytopenia Due to Chemotherapy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pancytopenia Due to Chemotherapy
Use these documentation templates to ensure complete and accurate documentation for Pancytopenia Due to Chemotherapy. These templates include all required elements for proper coding and billing.
Oncology Progress Note
Specialty: OncologyRequired Elements
- Assessment of pancytopenia
- Link to chemotherapy
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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