Hairy cell leukemia: Difference between revisions
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{{ICD10 transition status | {{ICD10 transition status | ||
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| InitialEditorAssigned = Debbie Page-Newton | | InitialEditorAssigned = Debbie Page-Newton | ||
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{{ICD10 dx | {{ICD10 dx | ||
| MinimumCombinedCodes = | |||
| ICD10 Code=C91.4 | | ICD10 Code=C91.4 | ||
| BugRequired= | | BugRequired= | ||
}} | }} | ||
{{ICD10 category|Heme/immunology}}{{ICD10 category|Neoplastic}}{{ICD10 category|Leukemia}} | |||
== Additional Info == | == Additional Info == | ||
*Hairy cell leukemia is a rare, slow-growing cancer of the blood in which | *Hairy cell leukemia is a rare, slow-growing cancer of the blood in which the bone marrow makes too many B cells (lymphocytes), a type of white blood cell that fights infection. These excess B cells are abnormal and look "hairy" under a microscope. | ||
{{ICD10 Guideline leukemia vs lymphoma}} | |||
{{ICD10 Guideline Cancer}} | |||
== Alternate ICD10s to consider coding instead or in addition == | |||
{{ListICD10Category | categoryName = Leukemia}} | |||
== | == Candidate [[Combined ICD10 codes]] == | ||
*[[Chronic lymphocytic leukemia (CLL)]] | *[[Chronic lymphocytic leukemia (CLL)]] | ||
== | == Related CCI Codes == | ||
{{Data Integrity Check List}} | |||
== Related Articles == | == Related Articles == | ||
{{Related Articles}} | {{Related Articles}} | ||
{{ICD10 footer}} | {{ICD10 footer}} | ||
{{EndPlaceHolder}} | {{EndPlaceHolder}} |
Latest revision as of 10:26, 2024 March 21
ICD10 Diagnosis | |
Dx: | Hairy cell leukemia |
ICD10 code: | C91.4 |
Pre-ICD10 counterpart: | none assigned |
Charlson/ALERT Scale: | Any malignancy, including lymphoma and leukemia, except of skin |
APACHE Como Component: | Immunocompromised |
APACHE Acute Component: | none |
Start Date: | |
Stop Date: | |
External ICD10 Documentation |
This diagnosis is a part of ICD10 collection.
Additional Info
- Hairy cell leukemia is a rare, slow-growing cancer of the blood in which the bone marrow makes too many B cells (lymphocytes), a type of white blood cell that fights infection. These excess B cells are abnormal and look "hairy" under a microscope.
Leukemia vs Lymphoma
Any lymphoma may have a leukemic phase where the abnormal clonal cells appear in the circulation. Though this is sometimes referred to as a "leukemia", even by some oncologists, that is technically incorrect and ICD10 considers them to be lymphomas. This applies to essentially ALL so-called B-cell leukemias, which are actually lymphomas. It also applies to "NK-cell leukemia" which is also a lymphoma
As such, the following so-called "leukemias" should be coded as follows:
- So-called B-cell leukemias describes several different types of lymphoid lymphomas which affect B cells -- and all these should be coded as Lymphoma, NOS
- "B cell chronic lymphocytic leukemia"
- "Precursor B cell lymphoblastic leukemia"
- "Acute Lymphoblastic leukemia, mature B cell type"
- "B cell prolymphocytic leukemia"
- So-called "NK-cell leukemia" -- code as T-cell lymphoma
- Aggressive NK-cell leukemia (also called aggressive NK-cell lymphoma, or ANKL), is a very rare type of NHL. The body makes large numbers of NK cells that are larger than normal. It is grouped with T-cell lymphomas.
- There is a very rare slow-growing (indolent) type of NK-cell leukemia that has a more favorable prognosis. It is called chronic NK-cell leukemia and is treated like T-cell large granular lymphocytic leukemia.
- The most common type of lymphoid leukemia is B-cell chronic lymphocytic leukemia.
Using ICD10 Malignancy Codes as a Comorbid Diagnosis
- Any cancer/malignancy (either a "solid tumor" or a leukemia/lymphoma/bone marrow malignancy/"liquid tumor", i.e. any ICD10 code from C00-C99) can be a comorbid diagnosis --- BUT it's vital to distinguish malignancies in this category based on whether they are believed to be cured or not.
- If it's still present (or believed to be present), then just include the code for the specific cancer as a comorbid diagnosis.
- If INSTEAD, it's presumed cured, then in the "bin" of comorbid diagnoses combine the code for the specific cancer with this code: Past history, cancer (any type), believed cured
Metastases
Metastasis codes: |
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Regarding Presumptive Diagnosis of Malignancy
- Rarely a presumptive diagnosis is made without any tissue confirmation. This generally occurs with:
- risk of obtaining tissue is very high
- plan would be palliative regardless
- patient would refuse care regardless.
- Our issue for how to code a presumed malignancy without definitive histopathologic proof is this:
- If the physicians are going to proceed with a treatment plan without that definitive histopathologic proof --- then code whatever is their best guess about what is present. Example: believed to be lung cancer with a big brain met, and they've decided NOT to do any biopsy but to give palliative radiation therapy, then you'd code lung cancer, and met to brain.
- If the plan is to obtain a definitive histopathologic diagnosis soon or in the future, then instead code: Neoplasm of uncertain behavior (i.e. not clear if benign or malignant), NOS
"work-up for cancer"
If the cancer has not been confirmed then it should not be coded as cancer. Code relevant test abnormal test results or symptoms.
Testing codes: |
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Symptom/Sign codes: |
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Example: |
"I have a patient who comes in with vague respiratory and gi symptoms. They did a chest xray and found a lung mass. They are now working him up for a probable lung ca, with mets to various places. In the old coding I would use ca-nyd. I actually use the ca nyd subcode a lot. I’ve talked to you about this before, because there is no ca nyd in icd10. You told me that you either have cancer or you don’t. For this particular patient I really wouldn’t have anything else I could code in icd10 for him. His symptoms are extremely vague. I don’t really like coding just symptoms, if there isn’t a proper admit diagnosis that fits better anyway. I found a “neoplasm of uncertain behavior (i.e. uncertain if benign or malignant), nos”, but I don’t really like that one. It doesn’t really fit. Is it possible to get something like “admit for workup of malignancy”, or something along those lines?" (Debbie, 12:40, 2018 October 4 (CDT)) How should this be coded? Ttenbergen 12:40, 2018 October 4 (CDT) |
Alternate ICD10s to consider coding instead or in addition
Leukemia codes: |
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Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)
none found
Related Articles
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