Neutropenia ICD-10-CM codes

Category D70 covers neutropenia and agranulocytosis by cause: D70.0 congenital agranulocytosis, D70.1 agranulocytosis secondary to cancer chemotherapy, D70.2 other drug-induced agranulocytosis, D70.3 neutropenia due to infection, D70.4 cyclic neutropenia, D70.8 other neutropenia, and D70.9 neutropenia unspecified. D70.9 is the default when the provider documents neutropenia without a cause. Chemotherapy-induced neutropenia is by far the most frequently coded, and the provider must link the neutropenia to the chemotherapy for D70.1 to be assigned.

The tabular instructs to use an additional code for any associated fever, R50.81 (fever presenting with conditions classified elsewhere). Neutropenic fever is therefore coded as the D70 code first, followed by R50.81, not as R50.9. For D70.1 and D70.2, an additional adverse effect code is also required: T45.1X5A for antineoplastic drugs or the appropriate T36 to T50 code with a fifth or sixth character of 5 for other drugs. If an infection is identified as the cause of the fever, code the infection as well.

D72.819 (decreased white blood cell count, unspecified) is for a documented low WBC that the provider has not called neutropenia; do not code D70.9 from a differential alone. When neutropenia is part of chemotherapy-induced pancytopenia, D61.810 is assigned instead of separate codes for each cell line. Sequencing: when a patient is admitted for neutropenic fever after chemotherapy, D70.1 is principal, followed by R50.81, T45.1X5A, and the malignancy code.