ICD-9-CM for Hospitals and Payers – Volumes 1, 2, & 3 201 Expert
International Classification of Diseases 9th Revision Clinical Modification Sixth Edition
Edited by: Anita C. Hart, RHIA, CCS, CCS-P Melinda S. Stegman, MBA, CCS Beth Ford, RHIT, CCS
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Codes Valid October 1, 201, through September 30, 201 Index to Diseases Abnormal, abnormality, abnormalities Index A Ablutomania 300.3 Abnormal, abnormality, abnormalities — Abnormal, abnormality, abnormalities — Abnormal, abnormality, abnormalities — see also Anomaly — continued see also Anomaly — continued AAT (alpha-1 antitrypsin) deficiency 273.4 see also Anomaly erythrocytes — continued hemoglobin (see also Disease, hemoglobin) AAV (disease) (illness) (infection) — see Human acid-base balance 276.4 congenital, with perinatal jaundice 282.7 immunodeficiency virus (disease) (ill- fetus or newborn — see Distress, fetal 282.9 [774.0] trait — see Trait, hemoglobin, abnormal ness) (infection) adaptation curve, dark 368.63 Eustachian valve 746.9 hemorrhage, uterus — see Hemorrhage, Abactio — see Abortion, induced alveolar ridge 525.9 excitability under minor stress 301.9 uterus Abactus venter — see Abortion, induced amnion 658.9 S fat distribution 782.9 histology NEC 795.4 Abarognosis 781.99 affecting fetus or newborn 762.9 feces 787.7 increase Abasia (-astasia) 307.9 anatomical relationship NEC 759.9 fetal heart rate — see Distress, fetal in atactica 781.3 apertures, congenital, diaphragm 756.6 fetus NEC appetite 783.6 choreic 781.3 auditory perception NEC 388.40 affecting management of pregnancy — development 783.9 hysterical 300.11 autosomes NEC 758.5 see Pregnancy, management af- involuntary movement 781.0 paroxysmal trepidant 781.3 13 758.1 fected by, fetal jaw closure 524.51 spastic 781.3 18 758.2 causing disproportion 653.7 S karyotype 795.2 trembling 781.3 21 or 22 758.0 affecting fetus or newborn 763.1 knee jerk 796.1 trepidans 781.3 D1 758.1 causing obstructed labor 660.1 S labor NEC 661.9 S Abderhalden-Kaufmann-Lignac syndrome affecting fetus or newborn 763.1 affecting fetus or newborn 763.7 E3 758.2 (cystinosis) 270.0 findings without manifest disease — see laboratory findings — see Findings, abnor- G 758.0 Abdomen, abdominal — see also condition Findings, abnormal mal ballistocardiogram 794.39 accordion 306.4 fluid length, organ or site, congenital — see Dis- basal metabolic rate (BMR) 794.7 acute 789.0 S amniotic 792.3 tortion biosynthesis, testicular androgen 257.2 angina 557.1 cerebrospinal 792.0 liver function test 790.6 blood level (of) burst 868.00 peritoneal 792.9 loss of height 781.91 cobalt 790.6 convulsive equivalent (see also Epilepsy) pleural 792.9 loss of weight 783.21 copper 790.6 345.5 S synovial 792.9 lung shadow 793.1 iron 790.6 heart 746.87 vaginal 792.9 mammogram 793.80 lead 790.6 muscle deficiency syndrome 756.79 S calcification 793.89 lithium 790.6 forces of labor NEC 661.9 obstipum 756.79 calculus 793.89 magnesium 790.6 affecting fetus or newborn 763.7 Abdominalgia 789.0 S microcalcification 793.81 mineral 790.6 form, teeth 520.2 periodic 277.31 Mantoux test 795.5 zinc 790.6 function studies Abduction contracture, hip or other joint — membranes (fetal) blood pressure auditory 794.15 see Contraction, joint affecting fetus or newborn 762.9 elevated (without diagnosis of hyperten- bladder 794.9 Abercrombie’s syndrome (amyloid degener- complicating pregnancy 658.8 S sion) 796.2 brain 794.00 ation) 277.39 cardiovascular 794.30 menstruation — see Menstruation
low (see also Hypotension) 458.9 — Abnormal, abnormality, abnormalities AAT Aberrant (congenital) — see also Malposition, metabolism (see also condition) 783.9 reading (incidental) (isolated) (non- endocrine NEC 794.6 congenital movement 781.0 specific) 796.3 kidney 794.4 adrenal gland 759.1 disorder NEC 333.90 blood sugar 790.29 liver 794.8 blood vessel NEC 747.60 sleep related, unspecified 780.58 bowel sounds 787.5 nervous system arteriovenous NEC 747.60 specified NEC 333.99 breathing behavior — see Respiration central 794.00 cerebrovascular 747.81 head 781.0 caloric test 794.19 peripheral 794.19 gastrointestinal 747.61 involuntary 781.0 cervix (acquired) NEC 622.9 oculomotor 794.14 lower limb 747.64 specified type NEC 333.99 congenital 752.40 pancreas 794.9 renal 747.62 placenta 794.9 muscle contraction, localized 728.85 in pregnancy or childbirth 654.6 S spinal 747.82 pulmonary 794.2 myoglobin (Aberdeen) (Annapolis) 289.9 causing obstructed labor 660.2 S upper limb 747.63 retina 794.11 narrowness, eyelid 743.62 affecting fetus or newborn 763.1 breast 757.6 special senses 794.19 optokinetic response 379.57 chemistry, blood NEC 790.6 endocrine gland NEC 759.2 spleen 794.9 organs or tissues of pelvis NEC chest sounds 786.7 gastrointestinal vessel (peripheral) 747.61 thyroid 794.5 in pregnancy or childbirth 654.9 S chorion 658.9 S hepatic duct 751.69 vestibular 794.16 affecting fetus or newborn 763.89 affecting fetus or newborn 762.9 lower limb vessel (peripheral) 747.64 gait 781.2 causing obstructed labor 660.2 S chromosomal NEC 758.89 pancreas 751.7 hysterical 300.11 affecting fetus or newborn 763.1 analysis, nonspecific result 795.2 parathyroid gland 759.2 gastrin secretion 251.5 origin — see Malposition, congenital autosomes (see also Abnormal, auto- peripheral vascular vessel NEC 747.60 globulin palmar creases 757.2 somes NEC) 758.5 pituitary gland (pharyngeal) 759.2 cortisol-binding 255.8 Papanicolaou (smear) fetal, (suspected) affecting management renal blood vessel 747.62 thyroid-binding 246.8 anus 796.70 of pregnancy 655.1 S sebaceous glands, mucous membrane, glucagon secretion 251.4 with sex 758.81 mouth 750.26 glucose 790.29 atypical squamous cells clinical findings NEC 796.4 spinal vessel 747.82 in pregnancy, childbirth, or puerperium cannot exclude high grade communication — see Fistula spleen 759.0 648.8 S squamous intraepithe- configuration of pupils 379.49 testis (descent) 752.51 fetus or newborn 775.0 lial lesion (ASC-H) coronary thymus gland 759.2 non-fasting 790.29 796.72 artery 746.85 thyroid gland 759.2 gravitational (G) forces or states 994.9 of undetermined significance vein 746.9 upper limb vessel (peripheral) 747.63 hair NEC 704.2 (ASC-US) 796.71 cortisol-binding globulin 255.8 Aberratio hard tissue formation in pulp 522.3 cytologic evidence of malignancy course, Eustachian tube 744.24 lactis 757.6 head movement 781.0 796.76 creatinine clearance 794.4 testis 752.51 heart high grade squamous intraepithe- dentofacial NEC 524.9 Aberration — see also Anomaly rate lial lesion (HGSIL) 796.74 functional 524.50 chromosome — see Anomaly, chromo- fetus, affecting liveborn infant low grade squamous intraepithe- specified type NEC 524.89 some(s) before the onset of labor 763.81 lial lesion (LGSIL) 796.73 development, developmental NEC 759.9 distantial 368.9 during labor 763.82 glandular 796.70 bone 756.9 mental (see also Disorder, mental, nonpsy- unspecified as to time of onset specified finding NEC 796.79 central nervous system 742.9 chotic) 300.9 763.83 cervix 795.00 direction, teeth 524.30 Abetalipoproteinemia 272.5 intrauterine with Dynia (see also Defect, coagulation) 286.9 Abionarce 780.79 before the onset of labor 763.81 atypical squamous cells Ebstein 746.2 Abiotrophy 799.89 during labor 763.82 cannot exclude high grade echocardiogram 793.2 Ablatio unspecified as to time of onset squamous intraepithe- echoencephalogram 794.01 placentae — see Placenta, ablatio 763.83 lial lesion (ASC-H) echogram NEC — see Findings, abnormal, retinae (see also Detachment, retina) 361.9 newborn 795.02 structure Ablation before the onset of labor 763.81 of undetermined significance electrocardiogram (ECG) (EKG) 794.31 pituitary (gland) (with hypofunction) 253.7 during labor 763.82 (ASC-US) 795.01 electroencephalogram (EEG) 794.02 placenta — see Placenta, ablatio unspecified as to time of onset cytologic evidence of malignancy electromyogram (EMG) 794.17 uterus 621.8 763.83 795.06 ocular 794.14 Ablepharia, ablepharon, ablephary 743.62 shadow 793.2 high grade squamous intraepithe- electro-oculogram (EOG) 794.12 Ablepsia — see Blindness sounds NEC 785.3 lial lesion (HGSIL) 795.04 Ablepsy — see Blindness electroretinogram (ERG) 794.11 erythrocytes 289.9
S Additional Digit Required — Refer to the Tabular List for Digit Selection 2 Subterms under main terms may continue to next column or page 2013 ICD-9-CM wx Revised Text l New Line s Revised Code Volume 2 — 1 ICD9 V1 Hospital book.book Page 179 Tuesday, Ju ne 29, 2010 3:46 PM
Tabular List Diseases of the Digestive System 531–533.3 Diseases of the Dige Stomach b 532 Duodenal ulcer Esophagus 1 erosion (acute) of duodenum ulcer (peptic): duodenum Diaphragm postpyloric Cardiac portion Stomach Fundus Use additional E code to identify drug, if drug-induced Pylorus 2 peptic ulcer NOS (533.0-533.9) Greater curvature The following fifth-digit subclassification is for use with category 532: 0 without mention of obstruction Pancreas 1 with obstruction Sphincter stive System of Oddi Pancreatic DEF: Ulcers in duodenum due to action of gastric acid and pepsin on mucosa Common duct decreasing resistance to ulcers. bile duct AHA: 4Q, ‘90, 27; 1Q, ‘91, 15 Proximal duodenum § c 532.0 Acute with hemorrhage a [0-1] For code 532.00: 251.5, 456.0, 530.20-530.21, 530.7, 530.82, 530.85, 531.00-534.91, 535.01, 535.11, 535.21, 535.31, 535.41, 535.51, 535.61, 535.71, 537.3, 537.83, 537.89-538, 562.02-562.03, b 531 Gastric ulcer 562.12-562.13, 569.3, 569.85, 578.0-578.9 1 ulcer (peptic): AHA: 4Q, ‘90, 22 prepyloric § c 532.1 Acute with perforation a pylorus CC Excl: stomach [0-1] See code 532.0 Use additional E code to identify drug, if drug-induced § c 532.2 Acute with hemorrhage and perforation a 2 peptic ulcer NOS (533.0-533.9) [0-1] CC Excl: See code 532.0 The following fifth-digit subclassification is for use with category 531: § c 532.3 Acute without mention of hemorrhage or bB 0 without mention of obstruction [0-1] perforation 1 with obstruction For code 532.30: 251.5, 456.0, 530.7, 530.82, 531.00-534.91, 535.01, DEF: Destruction of tissue in lumen of stomach due to action of gastric acid 535.11, 535.21, 535.31, 535.41, 535.51, 535.61, 535.71, 537.3, and pepsin on gastric mucosa decreasing resistance to ulcers. 537.83-538, 562.02-562.03, 562.12-562.13, 569.3, 569.85, For code 532.31: AHA: 1Q, ‘91, 15; 4Q, ‘90, 27 578.0-578.9; 251.5, 456.0, 530.20-530.21, 530.7, 530.82, 530.85, 531.00-534.91, 535.01, 535.11, 535.21, 535.31, § c 531.0 Acute with hemorrhage a 535.41, 535.51, 535.61, 537.3, 537.83, 537.89-538, 562.02-562.03, [0-1] CC Excl: 251.5, 456.0, 530.20-530.21, 530.7, 530.82, 530.85, 562.12-562.13, 569.3, 569.85, 578.0-578.9 531.00-534.91, 535.01, 535.11, 535.21, 535.31, 535.41, 535.51, § c 532.4 Chronic or unspecified with hemorrhage a 535.61, 537.83, 537.89-538, 562.02-562.03, 562.12-562.13, 569.3, CC Excl: 569.85, 578.0-578.9 [0-1] See code 532.0 K26.4 I-10 AHA: N-D, ‘84, 15 Chronic/unspecified duodenal ulcer w/hemorrhage § 531.1 Acute with perforation § c 532.5 Chronic or unspecified with perforation a c a CC Excl: [0-1] CC Excl: See code 531.0 [0-1] See code 532.0
§ 531.2 Acute with hemorrhage and perforation § c 532.6 Chronic or unspecified with hemorrhage and a 531–533.3 c a perforation [0-1] CC Excl: See code 531.0 [0-1] CC Excl: See code 532.0 § c 531.3 Acute without mention of hemorrhage b B [0-1] or perforation § c 532.7 Chronic without mention of hemorrhage or b peforation CC Excl: See code 531.0 [0-1] CC Excl: For code 532.71: See code 532.0 § c 531.4 Chronic or unspecified with hemorrhage a [0-1] CC Excl: See code 531.0 § c 532.9 Unspecified as acute or chronic, without mention of b AHA: 4Q, ‘90, 22 [0-1] hemorrhage or perforation K25.4 Chronic/unspecified gastric ulcer w/hemorrhage I-10 CC Excl: For code 532.91: See code 532.0 K26.9 Duodenal ulcer uns acute/chronic w/o hem/perf I-10 § c 531.5 Chronic or unspecified with perforation a [0-1] CC Excl: See code 531.0 b 533 Peptic ulcer, site unspecified § c 531.6 Chronic or unspecified with hemorrhage a 1 gastroduodenal ulcer NOS [0-1] and perforation peptic ulcer NOS CC Excl: See code 531.0 stress ulcer NOS Use additional E code to identify drug, if drug-induced § c 531.7 Chronic without mention of hemorrhage b [0-1] or perforation 2 peptic ulcer: CC Excl: For code 531.71: duodenal (532.0-532.9) see code 531.0 gastric (531.0-531.9) § c 531.9 Unspecified as acute or chronic, without b The following fifth-digit subclassification is for use with category 533: [0-1] mention of hemorrhage or perforation 0 without mention of obstruction CC Excl: For code 531.91: see code 531.0 1 with obstruction K25.9 Gastric ulcer uns acute/chronic w/o hem/perf I-10 DEF: Ulcer of mucous membrane of esophagus, stomach or duodenum due to gastric acid secretion. AHA: 1Q, ‘91, 15; 4Q, ‘90, 27 § c 533.0 Acute with hemorrhage a [0-1] CC Excl: See code 532.0 § c 533.1 Acute with perforation a [0-1] CC Excl: See code 533.0 § c 533.2 Acute with hemorrhage and perforation a [0-1] CC Excl: See code 533.0 § c 533.3 Acute without mention of hemorrhage bB [0-1] and perforation CC Excl: See code: 533.0
§ Requires fifth digit. Valid digits are in [brackets] under each code. See appropriate category for codes and definitions. b c Additional Digit Required Unacceptable PDx Manifestation Code Hospital Acquired Condition wx Revised Text l New Code s Revised Code Title 2013 ICD-9-CM Volume 1 – 179 ICD9 v3H .fm Page 171 W ednesday, June 30, 2010 10:46 AM
Tabular List Operations on the Musculoskeletal System 81.55–81.85 Operations on the Musculoskeletal System Total Knee Replacement Percutaneous Vertebral Augmentation Spinal cord Condyle Vertebral component body Tube Femur Inflated balloon
Prosthesis Patella Fractured vertebra Plateau Tibia component Disc
The cavity is filled with bone cement Vertebroplasty 81.66 Percutaneous vertebral augmentation Lamina Arcuplasty Insertion of inflatable balloon, bone tamp, or other device displacing (removing) (compacting) bone to create a space (cavity) (void) prior to Injection of bone cement the injection of bone void filler (cement) (polymethylmethacrylate) (PMMA) or other Body Spinous into fracture site process substance Lateral view of Kyphoplasty fractured body of SKyphoplasty thoracic vertebra Spineoplasty 2 percutaneous vertebroplasty (81.65) AHA: 1Q, ‘07, 5, 7; 3Q, ’06, 13; 4Q, ’04, 126 81.55 Revision of knee replacement, not otherwise TIP: Assign a separate code from subcategory 77.4 for bone specified biopsy, if performed with percutaneous vertebral Code also any removal of (cement) (joint) spacer augmentation. (84.57) b 81.7 Arthroplasty and repair of hand, fingers, and wrist 2 arthrodesis of knee (81.22) 1 arthroplasty of hand and finger with: revision of knee replacement, components external traction or fixation specified (00.80-00.84) graft of bone (chips) or cartilage AHA: 4Q, ’05, 113; 2Q, ‘97, 10 internal fixation device or prosthesis 81.56 Total ankle replacement 5 2 operations on muscle, tendon, and fascia of hand 81.57 Replacement of joint of foot and toe (82.01-82.99) DEF: Plastic surgery of hand, fingers and wrist joints. 81.59 Revision of joint replacement of lower 81.71 Arthroplasty of metacarpophalangeal and 81.55–81.85 extremity, not elsewhere classified interphalangeal joint with implant b 81.6 Other procedures on spine 81.72 Arthroplasty of metacarpophalangeal and NOTE Number of vertebrae interphalangeal joint without implant The vertebral spine consists of 25 vertebrae in the following AHA: 1Q, ‘93, 28 order and number: 81.73 Total wrist replacement cervical: C1 (atlas), C2 (axis), C3, C4, C5, C6, C7 Arthroplasty of carpocarpal or thoracic or dorsal: T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, 81.74 carpometacarpal joint with implant T12 lumbar and sacral: L1, L2, L3, L4, L5, S1 81.75 Arthroplasty of carpocarpal or Coders should report only one code from the series carpometacarpal joint without implant 81.62-81.64 to show the total number of vertebrae AHA: 3Q, ‘93, 8 fused on the patient. 81.79 Other repair of hand, fingers, and wrist Code also the level and approach of the fusion or refusion (81.00-81.08, 81.30-81.39) b 81.8 Arthroplasty and repair of shoulder and elbow AHA: 4Q, ’03, 99 1 arthroplasty of upper limb NEC with: 81.62 Fusion or refusion of 2-3 vertebrae external traction or fixation AHA: w1Q, ‘10, 23;x 2Q, ’09, 4-5; 2Q, ‘08, 14; 1Q, ‘08, 5; 1Q, graft of bone (chips) or cartilage ‘07, 20; 1Q, ’06, 12, 13; 4Q, ’05, 123; 4Q, ’03, 99 internal fixation device or prosthesis 81.63 Fusion or refusion of 4-8 vertebrae s 81.80 Other total shoulder replacement AHA: w1Q, ‘10, 23;x 4Q, ’03, 99-101 2 wreverse total shoulder replacement 81.64 Fusion or refusion of 9 or more vertebrae (81.88)x AHA: 2Q, ’08, 5 AHA: 4Q, ’03, 99 81.81 Partial shoulder replacement 81.65 Percutaneous vertebroplasty Injection of bone void filler (cement) 81.82 Repair of recurrent dislocation of shoulder (polymethylmethacrylate) (PMMA) into the AHA: 3Q, ‘95, 15 diseased or fractured vertebral body 81.83 Other repair of shoulder 2 kyphoplasty (81.66) AHA: 1Q, ‘02, 9; 4Q, ‘01, 51; 2Q, ‘00, 14; 3Q, ‘93, 5 percutaneous vertebral augmentation TIP: Assign for SLAP (superior labral anterior (81.66) posterior—glenoid labrum lesion) repair. AHA: 2Q, ’08, 15 81.84 Total elbow replacement Partial elbow replacement 81.85 Other repair of elbow
a b Additional Digit Required Valid OR Procedure Non-OR Procedure Adjunct Code 2013 ICD-9-CM October 2012 • Volume 3 – 171 2010 Changes for Hospital.fm Page 1 Friday, July 2, 2010 10:41 AM
ICD-9-CM Changes 2013: An Insider’s View
Volume 1 — Tabular List of Diseases and Injuries transfusions include myelodysplasia and certain anemias (e.g., sickle cell anemia). Signs and symptoms include darkening or “bronzing” of the skin, Chapter 2: Neoplasms (140–239) weakness and fatigue, heart palpitations, joint or abdominal pain, infertility, impotence, or cessation of menstruation. Early detection is essential to Schwannomatosis (237.73) and Other Neurofibromatosis prevent potentially serious complications of prolonged hemochromatosis; (237.79) which may result in liver damage, endocrine (e.g., pituitary, adrenal, thyroid) ● 237.73 Schwannomatosis suppression, arthritis, secondary diabetes, heart failure, and increased risk for opportunistic infections. Treatment includes therapeutic phlebotomy or ● 237.79 Other neurofibromatosis chelation therapy to remove excess serum iron, as indicated by monitoring Neurofibromatosis (NF) is a genetic disorder characterized by abnormal hemoglobin and serum ferritin concentrations. growth of tumors along various nerves. Genetic mutations prevent normal Coding Tips protein synthesis required to control cell production; thereby resulting in New code 275.01 Hereditary hemochromatosis includes diabetic and uncontrolled growth of cells manifesting as tumors. Ongoing clinical research “bronzed diabetic” hemochromatosis. This condition may also be endeavors to identify the mechanisms that control key proteins in order to documented as Hano-Chauffard (-Troisier) syndrome. suppress tumor growth. NF tumors arise from the connective and supportive cells’ nerve tissues, (e.g., myelin sheath), not the impulse-transmitting New code 275.02 Hemochromatosis due to repeated red blood cell neurons (nerve cells). The type of cell-supporting tissues involved in the transfusions is assigned for a condition due to repeated transfusion acquired tumor determines the type of neurofibromatosis. NF has been clinically in the treatment of a separately reportable causal condition. Code also the categorized into three genetically distinct groups; type 1 (NF1), type 2 (NF2), causal condition being treated by transfusion. Do not report a code from new and schwannomatosis. subcategory 998.8 Other and unspecified infusion and transfusion reactions for this condition. Schwannomatosis is a rare form of NF that is primarily due to genetic mutation of the SMARCB1/INI1 gene. As a result, multiple tumors grow along Report arthritis due to or associated with hemochromatosis with two codes: cranial, spinal, and peripheral nerves, characterized by the exception of 8th code 275.03 Other hemochromatosis followed by code 713.0 Arthropathy cranial nerve involvement. These patients do not develop vestibular tumors; associated with other endocrine and metabolic disorders. therefore, deafness is not associated with schwannomatosis as it is in type 2 disease. Dominant neurological symptoms include paresthesia, weakness, Cirrhosis of the liver specified as pigmentary, or due to bronzed diabetes is and severe debilitating pain. Schwannoma patients do not manifest the reported with code 275.01 Hereditary hemochromatosis. However, code neurofibromas characteristic of NF1 and NF2. 275.03 is assigned for cirrhosis of the liver due to hemochromatosis, NOS. Diagnosis may be established by magnetic resonance imaging (MRI), Report Recklinghausen-Appelbaum disease and von computed tomography (CT) scan, and x-rays to identify tumors in the body. Recklinhausen-Applebaum hemochromatosis with code 275.03 Other There is currently no cure or method of controlling the growth of NF tumors. hemochromatosis. Where possible, surgical resection of tumors may preserve physiological Scenario function and relieve pain. A patient with severe sickle-cell anemia presents with fatigue, heart Coding Tips palpitations, and joint pain. Diagnostic testing, physical exam, and review of Assign the appropriate fifth digit to report NF by type: 237.71 for type 1 treatment history are consistent with hemochromatosis due to multiple serial disease (von Recklinghausen's disease), code 237.72 for type 2 disease blood transfusions. (acoustic neurofibromatosis), and code 237.73 for schwannomatosis. Code Code Assignment 237.79 Other neurofibromatosis represents conditions not classifiable to 275.02 Hemochromatosis due to repeated red blood cell codes 237.71-237.73, whereas code 237.70 indicates NF, type not specified. transfusions Scenario 282.60 Sickle cell disease, unspecified A 40-year-old man presents with numbness, tingling, and painful tumors in his left arm. Family history is noncontributory. MRI of the head revealed no Transfusion-Associated Circulatory Overload (276.61) intracranial tumors, including vestibular schwannoma (VS), whereas MRI of ● 276.61 Transfusion associated circulatory overload the left arm showed well defined densely enhancing lesions in the medial ● 276.69 Other fluid overload compartment adjacent to the brachial artery and vein consistent with schwannoma arising from the median nerve. Transfusion-associated circulatory overload (TACO) is a volume overload that occurs several hours after initiation of transfusion due to a rapid rate of Code Assignment transfusion or massive volumes of blood or blood products. Underlying 237.73 Schwannomatosis cardiac or pulmonary pathology may exacerbate overload. Due to their Chapter 3: Endocrine, Nutritional and Metabolic Diseases and relative physiologic sensitivity, infants and the elderly are at an increased risk Immunity Disorders (240-279) for TACO, even though the transfusion volumes may be small in comparison with those of other patients. Incidences of TACO have been historically underreported due to differential diagnoses that present in a similar manner Hemochromatosis (Iron Overload) (275.01-275.09) with posttransfusion respiratory distress (e.g., TRALI, anaphylaxis). TACO may ● 275.01 Hereditary hemochromatosis be differentiated from TRALI in the effects of blood pressure; TACO patients ● 275.02 Hemochromatosis due to repeated red blood cell become hypertensive, whereas TRALI is associated with hypotension. Signs transfusions and symptoms of TACO include acute respiratory distress (e.g., dyspnea, orthopnea), increased blood pressure, peripheral edema and pulmonary 275.03 Other hemochromatosis ● edema secondary to congestive heart failure during or within six hours of ● 275.09 Other disorders of iron metabolism transfusion. Preventative identification of patients at risk for TACO is essential to ensure therapeutic administration of controlled rates of reduced volumes Hemochromatosis is an excessive accumulation of iron in the blood. of required blood components. Causation includes genetic predisposition (hereditary forms) or the secondary effects of a disease process requiring repeated red blood cell transfusions (acquired forms). Associated conditions that would require serial
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