Oncology & Hematology Coding Alert

Thrombocytopenia coding made easier You can expect fresh help coding for heparin-induced thrombocytopenia (HIT) come Oct. 1. Watch for These ICD-9 Changes Your 2009 ICD-9 manual will most likely include new code 289.84 (Heparin-induced thrombocytopenia). Take note: ICD-9 will also add helpful exclusion notes, reading "Excludes: Heparin-induced thrombocytopenia," for the following codes: - 287.4 -- Purpura and other hemorrhagic conditions; secondary thrombocytopenia - 289.82 -- Other specified diseases of blood and blood-forming organs; secondary hypercoagulable state. Here's Why You Need the Code HIT is a distinct clinico-pathologic syndrome that is among the most common causes of thrombocytopenia in a hospital setting, including in cancer patients, says Lawrence Rice, MD, chief of the Division of Hematology and clinical chief for hematology and oncology service for The Methodist Hospital at Weill Cornell Medical College in Houston, in his coding request presentation to the ICD-9-CM Coordination and Maintenance Committee. This condition is always potentially catastrophic as well as having a unique pathophysiology and testing regimen, Rice adds. Why not 287.4?: Rice says that 289.84 is a better option than using 287.4 because HIT is a hypercoagulable state, not a hemorrhagic condition. You can view Rice's presentation on the CDC Web site http://www.cdc.gov/nchs/ppt/icd9/att4_Rice_Sep07.ppt.