This page addresses follow-up questions and additional information pertinent to our webinar
Quarterly ICD-10 Coding Update: Third Quarter.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: In Coding Clinic, 3rd Quarter 2025, page 7, Coding Clinic states that when the provider documents dementia with disturbance of behavior and psychotic disorder, codes F03.B2, Unspecified dementia, moderate, with psychotic disturbance and R44.3, Hallucinations, unspecified for should be assigned for moderate dementia with disturbance of behavior and hallucinations. why doesn’t Coding Clinic recommend also assigning a code for the behavioral disturbance?
A: There are no Excludes notes preventing assigning codes for both dementia with psychotic and dementia with behavioral disturbances. Both disturbances may be coded. When documentation specifies dementia with disturbance of behavior and psychotic disorder, it is appropriate to assign codes for both the behavioral disturbance and the psychotic disturbance.
Q: Why is pancytopenia due to CAR T-cell therapy coded as a complication rather than an adverse effect like pancytopenia due to chemotherapy?
A: CAR T-cell therapy is not a conventional drug; it is a cell-based immunotherapy. Because it involves the use of modified immune cells rather than a chemical substance, it would be incorrect to classify resulting conditions, such as pancytopenia, as adverse effects of a drug or substance. Instead, pancytopenia in this context is coded as a complication, using ICD-10-CM code D61.818 (Other pancytopenia). Do not use D61.811 (Drug-induced pancytopenia), as CAR T-cell therapy does not meet the definition of a drug-induced condition.
Q: Should a code for insertion of the lead and removal of the lead also be reported for a temporary pacemaker placement?
A: No. Placement of a temporary pacemaker lead is not considered a device. The intent of the procedure is not to implant a device, but rather to perform cardiac pacing on a temporary basis.
Because of this, separate codes for insertion and removal of the lead are not reported. The entire procedure is fully captured with ICD-10-PCS code 5A1223Z (Performance of cardiac pacing, continuous, duration less than 24 hours, percutaneous approach).
Looking for additional information on this topic?
Meet the Presenter: Kristi Pollard, RHIT, CCS, CPC, CIRCC
Kristi is the Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.
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