Coding, Classification and Reimbursement

POEMS diagnosis code(s)?

  • 1.  POEMS diagnosis code(s)?

    Posted 01-11-2019 13:42
    I'm looking for some ICD-10-CM coding help on POEMS (POLYNEUROPATHY, ORGANOMEGALY, ENDOCRINOPATHY, MONOCLONAL PROTEIN AND SKIN CHANGES).  Is the coding based upon each individual item that is actually documented by the provider within the record, or should you stick strictly by the diagnostic statement of "POEMS" and assign code(s) based upon all the items under the acronym?  Or, is anyone aware of any code(s) which cover POEMS exclusively?

    I find a lot of contrasting information out there and no consensus, and none from any official resource either.

    Lamon Willis
    Director of Coding

  • 2.  RE: POEMS diagnosis code(s)?

    Posted 01-11-2019 22:23
    I don't find a specific code for this syndrome either.  According to the Official Coding Guidelines:
    I. B. 15. Syndromes
    Follow the Alphabetic Index guidance when coding syndromes. In the absence of Alphabetic Index guidance, assign codes for the documented manifestations of the syndrome. Additional codes for manifestations that are not an integral part of the disease process may also be assigned when the condition does not have a unique code.

    [Dorothy "Dotsy"] [Baxter] RHIA CCS
    [ICD-10-CM/PCS AHIMA Trainer Certificate holder]

  • 3.  RE: POEMS diagnosis code(s)?

    Posted 01-12-2019 10:11

    Mayo Clinic:
    POEMS syndrome - Symptoms and causes
    "POEM syndrome have an increased number of plasma cells."

    D72.89  Other specified disorder of white blood cells
    Abnormality of white blood cells NEC

    Specify any of the following that exist in the patient:

    P:  Polyneuropathy  E88.9  G63
    O:  Organomegaly - code to organ
    E:  E31.9  Endocrinopathy, unspecified...or specify existing
    M:  E88.09 Other disorder of plasma-protein metabolism, NEC
    S:  Skin changes

    Louise Smalling
    Senior Medical Coder

  • 4.  RE: POEMS diagnosis code(s)?

    Posted 01-13-2019 09:42
    There is an ICD9 Coding Clinic 2Q 1998 pg 11 for Poems syndrome. The advice is to use 273.8, Other disorders of plasma protein metabolism as the PDX and to assign the appropriate codes for the manifestations of the syndrome as additional diagnoses. In ICD10 this indexes to E88.09, Other disorders of plasma-protein metabolism, NEC.