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Wiki Autoimmune disease and immunosuppression coding

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amiller3

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I have a coding scenario I need assistance with. Are you able to code M06.9, Rheumatoid arthritis, unspecified with the code D89.89, Other specified disorders involving the immune mechanism, not elsewhere classified together, if the immunosuppression is due to the rheumatoid arthritis?
 
I'd want to see a little more of the record before answering definitively. Can you tell what is the reason for the immunosuppression in this patient?

If that isn't specified in the record, then I think you could use D89.89 first with the arthritis secondary, but I probably wouldn't use R06.9 since that is unspecified - I think a code from the M06.8- section would be more appropriate since it's specified what's causing the arthritis.

On the other hand, if the immunosuppression if due to a drug I wouldn't code it that way - you'd want to use a code for an adverse effect of the drug - e.g. T45.1X5A - as your primary code and then the rheumatoid arthritis as the secondary/manifestation code. You may want to consider querying the physician for clarification if you can't tell which is the case.
 
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thomas7331 said:
I'd want to see a little more of the record before answering definitively. Can you tell what is the reason for the immunosuppression in this patient?

If that isn't specified in the record, then I think you I could use D89.89 first with the arthritis secondary, but I probably wouldn't use R06.9 since that is unspecified - I think a code from the M06.8- section would be more appropriate since it's specified what's causing the arthritis.

On the other hand, if the immunosuppression if due to a drug I wouldn't code it that way - you'd want to use a code for an adverse effect of the drug - e.g. T45.1X5A - as your primary code and then the rheumatoid arthritis as the secondary/manifestation code. You may want to consider querying the physician for clarification if you can't tell which is the case.
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Thank you - you definitely answered my question, as it was generalized in nature.
 
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