Coding Rules Current as at 18-Oct-2016 08: 31

Abnormal, abnormality, abnormalities

- chemistry, blood

- - specified NEC R79.8

Assign Z92.1 Personal history of long term (current) use of anticoagulant as an additional diagnosis.

Q: 

What is the correct code assignment for bridging therapy for temporary cessation of an anticoagulant?

A:

Bridging therapy is a recent term used to describe the temporary discontinuation of long term oral anticoagulants (eg warfarin) and replacing with a short action agent such as clexane or heparin.

Patients on long term oral anticoagulants undergoing bridging therapy may be admitted because their INR levels are significantly lower than the therapeutic range (i.e. subtherapeutic INR or underwarfarinisation) in which case assign R79.8 as specified above.

When patients are admitted for a planned surgery and they receive bridging therapy prior to the surgery, assign a code for the condition requiring surgery as the principal diagnosis, followed by Z92.1 Personal history of long term (current) use of anticoagulant as per ACS 0303 Abnormal coagulation profile due to anticoagulants (See also Coding Rules: Anticoagulant therapy pre and post surgery).

Improvements to ICD-10-AM for abnormal coagulation profile due to anticoagulants will be considered for a future edition.