Immunocompromised ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for Immunocompromised

Immunocompromised individuals have weakened immune systems, making them more susceptible to infections and illnesses. In the International Classification of Diseases, 10th Revision (ICD-10), several codes are used to classify the various conditions and circumstances related to immunocompromised patients. 

Ensuring accurate identification and coding of medical conditions is vital in healthcare. Here are the frequently used ICD-10 codes for immunocompromised individuals and their clinical descriptions. Stay up-to-date with the latest codes, and ensure you provide the best possible care to your patients.

• D80.0 - Hereditary hypogammaglobulinemia: This code is used for individuals with congenital immunoglobulin deficiencies, leading to a weakened immune response.
• D83.0 - Common variable immunodeficiency (CVID): CVID is a primary immunodeficiency disorder characterized by low levels of immunoglobulins, making individuals prone to recurrent infections.
• D89.3 - Graft-versus-host disease (GVHD): GVHD occurs when transplanted cells or tissues attack the recipient's body. It primarily affects patients who have received bone marrow or stem cell transplants.
• B20 - Human immunodeficiency virus [HIV] disease: This code is used to classify HIV infections. It represents a virus that attacks the immune system, potentially leading to acquired immunodeficiency syndrome (AIDS).
• D89.821 - Postprocedural hypogammaglobulinemia, not elsewhere classified: This code is applied when immunodeficiency results from a medical procedure or treatment, like certain types of cancer therapy.
• D84.9 - Immunodeficiency, unspecified: When a patient's immunodeficiency doesn't fit a specific category, this code indicates a general state of immunocompromise.
• D89.0 - Sarcoidosis with organ involvement: Sarcoidosis can affect various organs, and in cases where it involves the immune system, this code is appropriate.
• D59.9 - Acquired hemolytic anemia, unspecified: Certain types of anemia can result from immune system dysfunction, making this an essential code for immunocompromised patients.
• B33.0 - Epidemic myalgia: This code represents epidemic myalgia (Bornholm disease), an illness caused by a Coxsackie B virus, which can affect immunocompromised individuals more severely.
• D84.1 - Defects in the complement system: The complement system plays a crucial role in the immune response. Defects in this system can lead to immunodeficiency and susceptibility to infections.

These ICD-10 codes are crucial for accurately documenting and tracking the conditions of immunocompromised individuals, ensuring appropriate healthcare management, and facilitating research on these conditions. Proper coding is vital for healthcare providers, insurers, and public health authorities to provide the best care and support for these patients.

Which Immunocompromised ICD Codes are Billable

Certain factors determine whether specific ICD-10 codes for immunocompromised conditions can be billed or not. These factors include the patient's insurance coverage, the healthcare provider's billing practices, and the medical necessity of the services rendered. 

However, some commonly used immunocompromised ICD-10 codes can be used as a general guideline.

• D80.0 - Hereditary hypogammaglobulinemia: Yes. 
• D83.0 - Common variable immunodeficiency (CVID): Yes.
• D89.3 - Graft-versus-host disease (GVHD): Yes.
• B20 - Human immunodeficiency virus [HIV] disease: Yes.
• D89.821 - Postprocedural hypogammaglobulinemia, not elsewhere classified: Yes.
• D84.9 - Immunodeficiency, unspecified: Yes.
• D89.0 - Sarcoidosis with organ involvement: Yes. 
• D59.9 - Acquired hemolytic anemia, unspecified: Yes.
• B33.0 - Epidemic myalgia: Yes.
• D84.1 - Defects in the complement system: Yes.

ICD-10 codes' billability varies based on the patient's unique circumstances, provider, and insurance coverage. Accurate coding and documentation of medical necessity are essential for successful reimbursement. Always consult with insurance companies and billing guidelines.

Clinical Information

• Immunocompromised individuals have weakened or impaired immune systems, which can result from various causes, including medical conditions, medications, or treatments.
• Different categories of immunocompromised patients include those with primary immunodeficiencies (inherited), secondary immunodeficiencies (acquired), and immunosuppressed due to medications, organ transplantation, or certain diseases like cancer and HIV.
• Immunocompromised individuals are at a higher risk of contracting and developing severe infections. Even common pathogens can lead to serious complications.
• Immunocompromised patients often require specific vaccination protocols to protect them from vaccine-preventable diseases. However, live vaccines are generally contraindicated due to the risk of causing the disease.
• Regular monitoring of immune function is crucial for immunocompromised individuals. This may involve blood tests to assess immunoglobulin levels, T-cell counts, and other immune markers.
• Strict infection control measures are essential to minimize the risk of exposure to pathogens. This includes hand hygiene, isolation precautions, and respiratory hygiene.
• Management of immunocompromised patients may involve immune-boosting therapies, antiviral medications, antibiotics, and antifungal agents when infections occur.
• Post-transplant patients require immunosuppressive drugs to prevent rejection, but this makes them highly susceptible to infections. Balancing immunosuppression and infection control is a complex task.
• Chemotherapy, radiation, and bone marrow transplants can weaken the immune system in cancer patients, necessitating careful monitoring and management of infections during treatment.
• Proper antiretroviral therapy (ART) is crucial to control HIV and maintain immune function in HIV-infected individuals.
• Educating patients and their caregivers on infection prevention and seeking immediate medical attention for signs of infection is essential.

Synonyms Include

• Immunosuppressed
• Weakened immune system
• Immunodeficient
• Susceptible to infections
• Compromised immunity