Wiki Chronic to Acute Leukemia

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valwy

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New to IP coding.
Patient is admitted with diagnosis:
Fever in an immunocompromised patient
Myelodysplastic syndrome
Chronic Lymphocytic leukemia (chemo 3 weeks PTA)

During the hospitalization, a bone marrow is performed and reveals that the CLL has transformed to acute lymphocytic leukemia.

Are both leukemias coded?
The CLL would be POA, how about the Acute Leukemia?
Would pancytopenia/thrombocytopenia/amemia be coded separately as a diagnosis since low CBC, WBC and PLT could be symptoms of the MDS, CLL an ALL?

Thanks for any feedback.
 
There is no excludes not preventing you from coding both but since you said one transformed into the other? I'm thinking you probably would only code one. This makes me think of staging of ulcers a 2 becomes a 3 it is still POA yes but you code the higher stage because the condition was evolving on admission. Or patient is admitted with sepsis and the condition evolves into severe sepsis, the condition was in fact POA however it decompensated further. Another example would be chronic diastolic heart failure that becomes acute on chronic would still be POA yes.

In the case of the anemia/thrombocytopenia/pancytopenia they are covered in the MDS (unless it was like drug-induced anemia or refractory anemia) as they are symptoms.
 
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