how would you report a patient with cyclic neutropenia with an associated fever

by Leann Metz 7 min read

AAPC Chapter 3 Flashcards - Cram.com

30 hours ago Neutropenia refers to lower-than-normal levels of neutrophils in the blood. A neutrophil (also known as a granulocyte or polymorphonuclear leukocyte) is a type of white blood cell produced in the bone marrow. White blood cells in general, and neutrophils in particular, are important for infection control in the body. >> Go To The Portal


Patients with autoimmune neutropenia will respond to G-CSF, similar to idiopathic neutropenia. This paper provides a step-wise approach to making the diagnosis in patients presenting with neutropenia. Patients with fever and severe neutropenia should always have a careful exam and receive antibiotics as soon as possible.

Full Answer

What are the symptoms of cyclic neutropenia?

Symptoms of cyclic neutropenia may include fever, a general feeling of ill health, and/or sores (ulcers) of the mucous membranes of the mouth. Individuals with low levels of neutrophils (neutropenia) are highly susceptible to recurrent infections.

How is cyclic neutropenia (kidney infection) diagnosed?

The diagnosis of cyclic neutropenia is often confirmed by blood work including measurement of an absolute neutrophil count that is less than 200/microL during periods of neutropenia on multiple days within at least 3 regularly spaced cycles. Genetic testing can additionally be helpful to confirm the diagnosis. [2] [3]

What is the NNEC code for cyclic neutropenia?

NEC Cyclic neutropenia is coded with D70.4 cyclic neutropenia. There are additional coding instructions for this code listed under the category D70 Neutropenia.

What is the prognosis of cyclic neutropenia?

The cycling seems to decrease with age and may disappear by age 30 in some patients. Individuals with cyclic neutropenia only have symptoms during times of neutropenia. At other times when their neutrophil levels are normal, they are not at an increased risk for infection and inflammation.

Which coding convention is used in a description of an ICD-10-CM code when the information in the medical record provides detail but no specific code exists?

21 Cards in this SetWhich coding convention is used in the description of an ICD-10-CM code when the information in the medical record provides detail, but no specific code exists? Refer to ICD-10-CM guidelines, section I.A.6.NECBMI codesCan only be reported as a secondary diagnosis.19 more rows

What are NEC and NOS considered in the ICD-10-CM code book?

The first is the alphabetic abbreviations “NEC” and “NOS.” NEC means “Not Elsewhere Classified” while NOS means “Not Otherwise Specified.” Simply put, NEC means the provider gave you a very detailed diagnosis, but the codes do not get that specific.

What is used in both the index and tabular list to enclose supplementary words?

( ) Parentheses are used in both the Alphabetic Index and the Tabular List to enclose 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. The terms within parentheses are called nonessential modifiers.

What should the word and be interpreted to mean when it appears in a title?

The word “and” should be interpreted to mean either “and” or “or” when it appears in a title.

When should a code for signs and symptoms be reported?

There are three general guidelines to follow for reporting signs and symptoms in ICD-10: When no diagnosis has been established for an encounter, code the condition or conditions to the highest degree of certainty, such as symptoms, signs, abnormal test results, or other reason for the visit.

What does NEC mean in ICD-10-CM?

NEC: "Not elsewhere classified" - used when there is no specific code available to represent the condition.

What are the sections of the ICD-10-CM Official guidelines for Coding and Reporting?

Section II includes guidelines for selection of principal diagnosis for non-outpatient settings. Section III includes guidelines for reporting additional diagnoses in non-outpatient settings. Section IV is for outpatient coding and reporting.

Why are ICD CM 10 guidelines important?

Importance of ICD-10-CM codes ICD-10-CM codes are important because they are more granular than ICD-10 codes and can provide more information about the severity of a patient's condition.

What are ICD-10 essential modifiers?

Essential modifiers appear next to a lead term or as subterms indented below lead terms in the alphabetical index and do affect the selection of target code. They describe essential differences in site, etiology or type of disorder and must appear in the clinical statement for the code to be assigned.

What is the standard system for reporting diagnoses?

The ICD-9-CM system is used in all venues of healthcare to report diagnoses. ICD-9-CM is based on the official version of the World Health Organization's 9th Revision of the International Classification of Diseases (ICD-9).

What word should be interpreted to mean associated with or due to when it appears in a code title the alphabetic index or the tabular list?

The word with or in should be interpreted to mean associated with or due to when it appears in a code title, the alphabetic index (either under a main term or subterm), or an instructional note in the tabular list.

When there is a code first note and an underlying condition is present the?

When a “code first” note is present which is caused by an underlying condition, the underlying condition is to be sequenced first if known. Coding of sequela generally requires two codes sequenced with the condition or nature of the sequela first and the sequela code second.

What is the term for a white blood cell that is low in neutrophils?

Neutropenia refers to lower-than-normal levels of neutrophils in the blood. A neutrophil (also known as a granulocyte or polymorphonuclear leukocyte) is a type of white blood cell produced in the bone marrow. White blood cells in general, and neutrophils in particular, are important for infection control in the body. A shortage of neutrophils render a person susceptible to infection.

Why are neutrophils important?

White blood cells in general, and neutrophils in particular, are important for infection control in the body. A shortage of neutrophils render a person susceptible to infection. Cyclic neutropenia (CyN) is not present all of the time. The number of circulating neutrophils decreases and normalizes on a regular basis.

What is the cause of cytokine?

CyN is caused by a change in the genetic instructions (a mutation) to make an enzyme for fighting infection. Neutropenia symptoms result when the bone marrow does not produce enough neutrophils, when neutrophils die early, or when these cells do not perform correctly.

Why is it important to have a family history for a cyn?

Having an accurate family history is important in diagnosing CyN because it can be an inherited condition. Your doctor might order genetic tests to find any gene mutations. He or she may also order blood tests to measure the level of neutrophils two to three times per week for about six weeks.

What is ARDS in medicine?

Acute respiratory distress syndrome (ARDS) Rupture of the spleen. A crisis of sickle cell disease in people with these disorders. If you are taking filgrastim and have any type of problem, including pain in the upper left abdomen and/or shoulder, you should get immediate medical attention.

What are the side effects of Filgrastim?

Antibiotics usually have some minor side effects, like diarrhea or yeast infections. Filgrastim side effects may include: 1 Headache 2 Joint and bone pain 3 Kidney problems 4 Acute respiratory distress syndrome (ARDS) 5 Rupture of the spleen 6 A crisis of sickle cell disease in people with these disorders

How rare is cyn?

CyN is rare. There are an estimated 1-2 cases per 1 million people worldwide. The figure is estimated at 0.5 to 1 per 1 million people in the US.

What is cyclic neutropenia?

Cyclic neutropenia is a rare blood disorder characterized by recurrent episodes of abnormally low levels of neutrophils (a type of white blood cell) in the body. Neutrophils are instrumental in fighting off infection by surrounding and destroying bacteria that enter the body. Symptoms of cyclic neutropenia may include fever, ...

How to diagnose cyclic neutropenia?

The diagnosis of cyclic neutropenia is often confirmed by blood work including measurement of an absolute neutrophil count that is less than 200/microL during periods of neutropenia on multiple days within at least 3 regularly spaced cycles. Genetic testing can additionally be helpful to confirm the diagnosis. [2] [3]

How long does cyclic neutropenia last?

This condition is characterized by recurrent episodes of neutropenia that recur every 14-35 days (most commonly around 21 days) and last between 3 and 5 days. During times of neutropenia, it may be more difficult for the body to fight bacteria, viruses, and infections. The severity of the resulting infections can vary and are often similar to the severity of the neutropenia itself. Resulting symptoms during periods of neutropenia may include:

How effective is G-CSF?

Treatment with granulocyte colony-stimulating factor (G-CSF), also called Neupogen, is effective in raising blood neutrophil counts in cyclic neutropenia. G-CSF treatment reduces the symptoms and problems of infections in almost all people . Treatment is may be started as early as age six months to one year. Studies indicate that treatment is effective with no adverse effects on growth, development, or pregnancy outcome with follow-up to age 18 years. [2]

What is a registry for research?

A registry supports research by collecting of information about patients that share something in common, such as being diagnosed with Cyclic neutropenia. The type of data collected can vary from registry to registry and is based on the goals and purpose of that registry.

Why do we post questions on GARD?

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

How to find a doctor for a syphilis?

You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

What is the code for cyclic neutropenia?

Cyclic neutropenia is coded with D70.4 Cyclic neutropenia. There are additional coding instructions for this code listed under the category D70 Neutropenia. Using those instructions, how would you report a patient with cyclic neutropenia with an associated fever?

What are the terms used when coding what?

The terms malignant, benign, in situ, and uncertain behavior are all terms used when coding what?

What is Z51.11 C57.7?

She is diagnosed with croup. The mother also wants the pediatrician to look at a rash that has developed on her leg. The pediatrician prescribes over the counter medication of acetaminophen for the croup and hydrocortisone cream for the rash on the leg.

Why code the postoperative diagnosis?

Code the postoperative diagnosis because it is the most definitive.

What does the default code represent?

The default code represents that condition is the most commonly associated with the main term.

What is the code for cyclic neutropenia?

Cyclic neutropenia is coded with D70.0 Cyclic neurtopenia. There are additional coding instructions for this code listed under the category D70 Neutropenia. Using those instructions, how would you report a patient with cyclic neutropenia with an associated fever?

Why are brackets used in the tabular list?

Brackets are used in the Tabular List to enclose synonyms, alternate wording, or explanatory phrases. Brackets are used in the Index of Diseases and Injuries to identify manifestation codes in which multiple coding and sequencing rules will apply

What is the code for urinary retention?

N40.1, R33.8 (listed as an additional code to report urinary retention)

How many codes are needed to report a condition?

This note indicates two codes are needed to report a condition and requires that the underlying disease (etiology) be coded first, and the manifestation be coded second

What is parentheses in medical terminology?

Parentheses are used to enclose supplementary words that may be present or absent in the statement of a disease or procedure. They do not affect the code (nonessential modifiers)

Is the residual condition coded first or secondary?

The residual condition (sequela) is coded first, and the code(s) for the cause of the sequela are coded secondary.