Wiki clarification needed, is "in setting of" the same as "with"?

[sandraII]

clarification needed, is "in setting of" the same as "with"?
example" worsening normocytic anemia in setting of CKD stage 4. code as D64.9 and N18.4 OR D63.1 anemia in chronic kidney disease? All thoughts welcome.

 

[thomas7331]

In this context, it does not matter whether these mean the same thing or not. As the ICD-10 guidelines instruct, when the term 'with' or 'in' appears in the index, the two conditions are presumed to have a causal relationship unless the provider has specifically documented that they are unrelated. Since the anemia and CKD are both documented, an the term 'in' falls under anemia in the index, this would be coded as N18.4 & D63.1. The statement 'in the setting of', in this case, has no bearing on the coding.

 

[sandraII]

In this context, it does not matter whether these mean the same thing or not. As the ICD-10 guidelines instruct, when the term 'with' or 'in' appears in the index, the two conditions are presumed to have a causal relationship unless the provider has specifically documented that they are unrelated. Since the anemia and CKD are both documented, an the term 'in' falls under anemia in the index, this would be coded as N18.4 & D63.1. The statement 'in the setting of', in this case, has no bearing on the coding.

Thank you. Sometimes I over think it!