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AHA Coding Clinic® for ICD-9 - 2006 Issue 2; Ask the Editor

Stem Cell Boost Reinfusion

The patient is a 64-year-old female with a history of refractory secondary myelodyplastic syndrome that has evolved into secondary acute myelogenous leukemia (AML). She also has non-Hodgkin’s lymphoma. The patient was admitted for induction chemotherapy and consolidation chemotherapy with high dose Busulfan/Cyclophospamide using previously collected and purged cryopreserved autologous stems cells. During the hospitalization, her AML was treated with induction chemotherapy followed by consolidation chemotherapy and autologous peripheral blood stem cell boost reinfusion. When queried, the physician stated that the stem cell boost/reinfusion involves the infusion of extra stem cell product for patients that experience delayed or poor engraftment (blood count recovery) after the initial stem cell transplant. Although the stem cell boost is technically identical to the stem cell transplant, the stem cell boost is not the same because it does not entail both high dose chemotherapy and radiotherapy (conditioning phase). How should this be coded? ...

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