Correct Coding of Drug-Induced Diarrhea from chemotherapy

I have a question in regards to drug-induced diarrhea, nausea, and vomiting from chemotherapy drugs.  The MD diagnosis the patient with colitis likely due to chemotherapy. In ICD-10 it codes to Toxic Gastroenteritis. K521 includes Drug-induced gastroenteritis and colitis. However, the coder has informed me of an ICD-9 Coding clinic, Fifth issue 1994 that states " do not assign code 558.2 toxic gastroenteritis"... Has anyone had any problems with coding drug-induced diarrhea from chemotherapy?

Comments

  • Can you post the entire 1994 coding clinic. I don't have those handy and am not sure if it even applies here.  Need to see the full entry.   It is very possible that the code verbiage and or includes notes has been updated since 1994 making that clinic null and void, not to mention the problems with the GEMS in cross walking I9 to I10 to see if we are even comparing apples to apples.  
  • I think this is the one they are referring to.

    Jeff



  • Thanks! Jeff, the above Coding Clinic is correct
  •  

    Any suggestion with this one, anxiously awaiting! :)

  • Thank you Jeff!

    Comparing the coding clinic to your scenario:
    Coding Clinic: "it is incorrect to assume that all cases of drug induced diarrhea are due to gastroenteritis"

    No assumption necessary: "The MD diagnosis the patient with colitis likely due to chemotherapy"

    K52.1 Includes note says "Drug-induced gastroenteritis and colitis".

    Is the coder insisting you are violating the coding clinic because you are "assuming"?  You aren't assuming...the diagnosis is right there so this coding clinic does not apply.   The coding clinic was addressing "Drug induced diarrhea".  This is irrelevant...that is not what you have documented.  In this particular chart, the doctor already said it was "drug-induced colitis"..there is no reason to even question if "drug induced diarrhea is the same as toxic gastroenteritis"....he said toxic colitis, not drug induced diarrhea.
  • Thank you so much for your time and effort on this one.
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