1. Understanding ICD-9-CM Coding
Mary Jo Bowie MS, RHIA, RHIT
Regina Schaffer AAS, RHIA, CPC

2. Diseases of the Blood and Blood-Forming Organs
CHAPTER
Diseases of the
Blood and
Blood-Forming Organs 9

3. Blood Composed of plasma Cellular elements Liquid portion
Erythrocytes or Red Blood Cells (RBC)
Leukocytes or White Blood Cells (WBC)
Thrombocytes or platelets

4. Anemia Decrease in red blood cells
Important to know the type of anemia
Review medical record
Query provider

5. Iron Deficiency Anemia
Category Code 280
Insufficient supply of iron
Blood loss
Inadequate dietary iron intake
Fourth-digit assignment for specific type of iron deficiency anemia

6. Other Deficiency Anemias
Fourth digit indicates type of deficiency
0 Pernicious anemia
1 Other vitamin B12 deficiency anemia
2 Folate-deficiency anemia
3 Megoblastic anemia, NEC

7. Other Deficiency Anemias
4 Protein-deficiency
8 Other specified nutritional deficiency
9 Unspecified deficiency anemia

8. Hemolytic Anemias
Red blood cells are broken down faster than they are produced
Acquired forms—category 283
Hereditary forms—category 282

9. Sickle-Cell Anemia/Trait
Inherited sickle-cell trait
Asymptomatic condition
Genetic trait from one parent
Sickle-cell anemia
Genetic trait from both parents
Abnormal type of hemoglobin in RBC
Additional code for crisis

10. Aplastic Anemia Failure of bone marrow to produce blood components
Congenital—code

11. Aplastic Anemia Acquired—code 284.8x Chronic systemic disease
Infection
Exposure to drugs
Radiation or other chemicals

12. Other Anemias Due to blood loss from trauma or injury Chronic illness
External or internal
Chronic or acute
Chronic illness
Admission for anemia—primary diagnosis
Admission for chronic illness—primary diagnosis

13. Coagulation Defects Deficiency in one or more clotting factors
Prolonged clotting time
Serious bleeding
Fourth digit identifies congenital:
Christmas Disease, Von Willebrand’s Disease

14. Coagulation Defects
Or acquired hemorrhagic disorders due to circulation anticoagulants

15. Anticoagulants Anticoagulant therapy
Medication therapy to prevent blood clots
Coumadin therapy
Prothrombin Time (PT)
Code condition and E934.2

16. Abnormal Prothrombin Time
If lab result is NOT due to anticoagulation therapy, code is assigned
Coder must read supporting documentation to assign proper code

17. Purpura and Other Hemorrhagic Conditions
Accumulation of blood under skin that forms pinpoint hemorrhages
Thrombocytopenia
Abnormal decrease in platelet count causing purpural hemorrhages

18. White Blood Cells 288 category code Neutropenia—288.00
Leukemia is not in this category