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Wiki Myelodysplatic syndrome with Pancytopenia

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m_albrecht

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Provider documented myelodysplastic syndrome and pancytopenia.
I looked up myelodysplastic syndrome:
1748954322183.png
Under myelodysplastic syndrome there is an entry for "with" - coding guidelines would allow us to presume a causal relationship between the two conditions.

Myelodysplastic syndrome, with, pancytopenia acquired - see Syndrome, myelodysplastic, pancytopenia:
1748954536825.png

There is no entry for pancytopenia under syndrome, myelodysplastic.
Would you code D46.Z? Or would you code D46.9 (myelodysplastic syndrome) and D61.818 (pancytopenia)?

Thanks for your help!
 
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I see what you mean. It has the same reference under "pancytopenia with myelodysplastic syndrome" in the alpha list. That appears to be an error in the alpha list.

I would code D46.9 and D61.818. Section I, B, 15 of the guidelines for Syndromes indicates to use an additional code for the manifestations that are not an integral part of the disease and the excludes 2 note for D46.- at D61.81 indicates both can be coded. I wouldn't use D46.Z since a type of myelodysplastic syndrome was not specified.

Do you have access to the coding clinic referenced under D61.818?
 
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