Leukemia ICD-10-CM codes

Leukemia is coded by cell line: C91 lymphoid (C91.0- acute lymphoblastic leukemia, C91.1- chronic lymphocytic leukemia of B-cell type), C92 myeloid (C92.0- acute myeloblastic leukemia, C92.1- chronic myeloid leukemia BCR/ABL-positive, C92.4- acute promyelocytic), C93 monocytic, C94 other specified leukemias, and C95 leukemia of unspecified cell type. C95.90 should be rare because the peripheral smear or bone marrow report will specify the lineage.

The fifth character is the remission status and is required on every code: 0 not having achieved remission, 1 in remission, and 2 in relapse. Not having achieved remission includes a newly diagnosed leukemia, one that failed to achieve remission, and leukemia with no remission status documented. A patient whose CLL is in remission is coded C91.11; when the provider documents relapse, C91.12. Because these codes describe current disease, a leukemia in remission is not a history code.

Z85.6 (personal history of leukemia) is appropriate only when the provider documents that the leukemia has been cured or eradicated with no ongoing treatment or surveillance directed at it; most patients remain on the C91 to C95 code with the in-remission character. Chemotherapy complications are coded in addition: D70.1 for agranulocytosis secondary to cancer chemotherapy with T45.1X5- for the adverse effect, and D61.810 for chemotherapy-induced pancytopenia. When the admission is solely for chemotherapy, Z51.11 is principal and the leukemia code follows.