EmailImmunosuppressed
Publication Date: March 2018
ICD 10 AM Edition: Tenth edition
Query Number: 3302
At our hospital we frequently encounter the term immunosuppressed.
An example of this was a woman who was admitted for a LLETZ. She had a history of a renal transplant and was on tacrolimus (an immunosuppressant) to prevent rejection. Notes from the attending doctor ordered that given her immunosuppression she be given metronidazole (oral) for 10 days.
There is no Index entry for immunosuppressed, but we note the following Index entries:
Immunocompromised status (acquired) (drug related) NEC D89.8 Other specified disorders involving the immune mechanism, not elsewhere classified
and
Immunodeficiency/drug related (acquired) D89.9 Disorder involving the immune mechanism, unspecified
Can the committee please advise how 'immunosuppressed' should be coded?
An example of this was a woman who was admitted for a LLETZ. She had a history of a renal transplant and was on tacrolimus (an immunosuppressant) to prevent rejection. Notes from the attending doctor ordered that given her immunosuppression she be given metronidazole (oral) for 10 days.
There is no Index entry for immunosuppressed, but we note the following Index entries:
Immunocompromised status (acquired) (drug related) NEC D89.8 Other specified disorders involving the immune mechanism, not elsewhere classified
and
Immunodeficiency/drug related (acquired) D89.9 Disorder involving the immune mechanism, unspecified
Can the committee please advise how 'immunosuppressed' should be coded?
Response
VICC sought clinical advice which stated that when there is documentation of a patient being ‘immunosuppressed’ it usually means by medical intervention rather than by disease, and that both (intervention and/or disease) result in immunocompromise.
Therefore, VICC considers that ‘immunosuppression’ is synonymous with ‘immunocompromised status’ and that it is appropriate to assign D89.8 Other specified disorders involving the immune mechanism, not elsewhere classified, when one of these terms is documented, and it meets ACS 0002 Additional diagnoses.
Therefore, VICC considers that ‘immunosuppression’ is synonymous with ‘immunocompromised status’ and that it is appropriate to assign D89.8 Other specified disorders involving the immune mechanism, not elsewhere classified, when one of these terms is documented, and it meets ACS 0002 Additional diagnoses.
