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ICD 9 code for "acute lymphoblastic leukemia with central nervous system relapse

Bonnie Posted Thu 26th of December, 2013 10:25:12 AM

Hi:
I am looking for an ICD 9 code for "acute lymphoblastic leukemia" with "central nervous system relapse". Does the CNS relapse indicate that the leukemia is in relapse? Would you code this to 204.02 or 204.00?
Thanks so much

SuperCoder Answered Thu 26th of December, 2013 16:58:57 PM

204.02 (Acute lymphoid leukemia, in relapse) appears correct. CNS relapse appears to be a common area of concern for ALL patients. Here's an excerpt from an article: "Most ALL relapses occur during treatment or within the first 2 years after treatment completion, although relapses have been reported to occur even after 10 years from diagnosis. The majority of relapses occur in the BM [bone marrow], either in an isolated form or combined with involvement of another site, mainly CNS or the testes; isolated CNS or testicular relapse or, much less frequently, relapse involving other extramedullary sites may also occur. Leukemia relapse represents the outgrowth of a clonal cell population not completely eliminated by treatment." http://bloodjournal.hematologylibrary.org/content/120/14/2807.full

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