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R/O myeloproliferative neoplasm (MPN)

Annette Posted Thu 29th of August, 2019 10:07:04 AM
JAK2 V617F Mutation Analysis RESULT: Negative for JAK2 V617F mutation Quantitative Reverse Transcriptase PCR for BCR-ABL1 Fusion RESULT: Negative for BCR-ABL1 fusion. What ICD10 would you assign? Thank you
SuperCoder Answered Fri 30th of August, 2019 05:59:51 AM

Hi Annette,

Hope you are keeping well.

For BCR/ABL-negative, ICD C92.20 is correct code. This code is used for Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission/Atypical chronic myeloid leukemia, BCR/ABL-negative with failed remission/Atypical chronic myeloid leukemia, BCR/ABL-negative NOS. However, in this code, the condition is it-self negative but not the result, so it would not be appropriate to for NEGATIVE RESULT.

As per coding guidelines, you should never report “rule-out” diagnoses.

By taking this approach, you avoid labeling a patient with an unconfirmed diagnosis while still allowing for your doctor/lab test reimbursement for services rendered, even if she cannot establish a definitive diagnosis through testing.

Watch out: The following phrases in your physician’s documentation can indicate that the physician has not formally diagnosed the patient with the condition or disease:

  • Probable
  • R/O or rule out
  • Suspected
  • Likely
  • Questionable
  • Possible
  • Still to be determined.

For example: You shouldn’t claim a diagnosis of cancer hoping you’ll be paid if the doctor has not (or cannot) establish definitively a cancer diagnosis, even if he notes “Rule out cancer” in the medical record.

So, if the test results come up Negative, you must bill sign and symptoms.

Hope this helps!

Annette Posted Fri 30th of August, 2019 08:39:59 AM
Please clarify. Do I go back to signs and symptoms on this case or assign the C92.20? Thank you
SuperCoder Answered Tue 03rd of September, 2019 03:36:20 AM

Hi Annette,

Hope you are doing good.

There are no specific diagnosis codes for JAK2 V617F mutation and BCR-ABL1 fusion negative results.

Since the results for JAK2 V617F mutation and BCR-ABL1 fusion are negative, then it is appropriate to go for sign and symptoms.

Hope this helps!

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