New onset Leukemia

dvitalone1

I have been receiving conflicting information from coding side concerning this question...........If Oncologist states “new onset leukemia” (pt had bone marrow during admission to confirm dx), is that enough or does he have to say “acute leukemia?” Any input would be greatly appreciated.

Dawn Vitalone, RN
CDI Specialist
Community Hospital
Munter, IN

sharon.cole

Our coders require clarification any time something is "new onset".

Sharon Cole, RN, CCDS
Providence Health Center
Case Management Dept
254.751.4256
srcole@phn-waco.org

evanspx@sutterhealth.org

Sharon: I can't find anything specific to the term "new onset' in Coding Clinic. I can refer you to the issues below addressing this issue indirectly. In my opinion, I would need to see documentation of 'acute' or 'exacerbation' in order to consider a new onset as an acute process. I can understand a counter view, however.

(Is this 'new onset" the initial diagnosis of an acute form of leukemia with Blast Cells, or could it be the initial diagnosis of a less sinister and chronic type of leukemia, such as a chronic lymphoid leukemia? Could both be revealed with and subsequently stated as " new onset"?

The software search I performed in Quantim has no index for the term 'new onset' referenced in Coding Clinic.


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AHA Coding Clinic

sharon.cole

Yes, that's why we query for any new onset.

Sharon Cole, RN, CCDS
Providence Health Center
Case Management Dept
254.751.4256
srcole@phn-waco.org

ssalinas

I don't think you can assume new onset leukemia to be acute.

Acute and chronic leukemia are two different classifications of the disease.

In chronic leukemia, the leukemia cells come from mature, abnormal cells and the cells grow slowly. The symptoms are different from acute leukemias.

In acute leukemia, the disease spreads quickly and undeveloped malignant blasts replace the normal cells.

Consequently new onset leukemia can be acute or chronic.

Sharon Salinas, CCS