Use These Codes for Anemia Following Bariatric Surgery
Question: We have a patient seeing one of our oncologists with a diagnosis of iron deficiency anemia following bariatric surgery. I'm not sure where to start on this one. Can you please give me instruction on where to begin? AAPC Forum Participant Answer: In a situation like this, you might be tempted to assign a code from K95.0.- (Complications of gastric band procedure) or K95.8- (Complications of other bariatric procedure). But that would be incorrect, as the code descriptors imply the codes are intended to report intra- or postoperative complications from the surgeries, such as infections, coded to K95.01 (Infection due to gastric band procedure) or K95.81 (Infection due to other bariatric procedure). While anemia can be regarded as a consequence of bariatric surgery, the condition is not caused by the procedure itself, but by poor absorption of nutrients caused, in turn, by the digestive process bypassing the duodenum, which is where iron is absorbed during the process. As such, this is a long-term consequence of the patient having the surgery, but not of the bariatric procedure during and immediately after the surgeon performed it. Instead, your best bet would be to use two codes to report both the condition and its cause. The first would be D50.8 (Other iron deficiency anemias), which has as its inclusion term “Iron deficiency anemia due to inadequate dietary iron intake.” However, that only tells part of the patient’s medical story. So, you would add Z98.84 (Bariatric surgery status), which indicates the patient has undergone bariatric surgery. Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC
