Diagnosis Coding for Immuno-compromise

  • May 6, 2021

    Patients who are immuno-compromised pose increased risks and challenges when treating, highlighting the importance of accurately identifying these patients. Immuno-compromised is a broad term caused by underlying conditions or through intentional suppression via medication therapy.

    Patients afflicted with chronic conditions such as AIDS and cancer are often in an immuno-compromised state. Additionally, patients can be immuno-compromised resulting from immuno-suppressant drug therapy used to suppress the immune system to keep certain disease processes under control, such as lupus, Crohn’s disease, rheumatoid arthritis, and rejection treatment for organ transplant status. Disorders involving the immune mechanism and immuno-deficiency are frequently miscoded when the cause of the immuno-compromised state is medication therapy or an underlying chronic condition.

    New codes went into effect October 1, 2020, to report the specific causes for a patient’s

    Immuno-compromised state. Find out how to apply these appropriately by reviewing our Immuno-deficiency and Immune Disorders tip sheet, part of our Premera Documentation and Coding Series for Providers, and for additional coding guidance and specific examples.

    For more information on this or other challenging diagnostic coding scenarios, or to propose a custom documentation and coding review for your practice, email ProviderClinicalConsulting@Premera.com.

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