Acute Blood loss anemia, i feel your pain

Need to throw this out there and see if anyone has experienced this and can help me.  On patients that have significant blood loss during surgery, our in house coding auditor, is of the opinion that if Acute Blood Loss Anemia,  has the words operative or peri operative before, the ABLA can not be coded as D62, Acute posthemorrhagic anemia,.  The explanation to me is that these terms are not included in the non essential modifiers.  Are non essential modifiers only the ones listed?
From the coding book directly: “Parentheses are used in both the index and tabular list to enclose nonessential modifiers; supplementary words that may be present or absent in the statement of a disease or procedure without affecting the code number to which it is assigned”
So for instance for anemia it’s got a bunch of nonessential modifiers or words that don’t actually affect the unspecified code:
Anemia (essential) (general)(hemoglobin deficiency) (infantile) (primary) (profound)
I’ve always viewed it as a list of words that may be used, but it’s not necessarily a conclusive list of all the words a doctor may throw around a diagnosis as they can’t possibly list all the words a doctor may use—this may be my own interpretation.
Thanks for your help

Comments

  • Our Coders DO code to D62
  • We would code D62 for "operative -" or "peri-operative acute blood loss anemia".
    There are lots of words documented in medical records that are not non-essential modifiers, yet they rarely, if ever, negate the coding of a diagnosis.  In this case, the provider is simply indicating the development timeline of the diagnosis and hinting at the etiology.

    Jeanne McCorkle BSN, RN, CCDS
  • Isn't that why they are called non-essential modifiers? Because it's not essential that they be documented? 
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