One thing to consider with "acute blood loss anemia"...it might as well be stated as acute blood loss with anemia. I have seen surgeons document this as expected according to the type of surgery and I have also seen surgeons document it based on the amount of blood loss recorded during surgery. Without treatment of the condition, especially in the era of clinical validation, I don't think this winds up being a condition that you can accurately assign a code to. Especially with Orthopedic surgeries, the reality is that those surgeries are bloody, thereby technically meeting the ABLA term but if it does not lengthen the stay and there is no aggressive treatment, I just don't think you can ethically code it.
Thank you for all of your thoughtful replies! My opinion is that CC4Q16p147-149 has created some confusion. It states in part, "regardless of whether a physician uses the new clinical criteria for sepsis, the old criteria, his personal clinical judgment, or something else to decide a patient has sepsis (and document it as such), the code for sepsis is the same-as long as sepsis is documented, regardless of how the diagnosis was arrived at, the code for sepsis can be assigned. Coders should not be disregarding physician documentation and deciding on their own, based on clinical criteria, abnormal test results, etc., whether or not a condition should be coded". Treatment is given in sepsis cases and therefore meets reportable criteria. Code assignment of any condition should be based on 2 things: 1) how & where it's documented and 2) reportable criteria. The 2019 Guidelines include: "As with all other diagnoses, the codes for psychoactive substance use disorders (F10.9-, F11.9-, F12.9-, F13.9-, F14.9-,F15.9-, F16.9-) should only be assigned based on provider documentation and when they meet the definition of a reportable diagnosis (see Section III, Reporting Additional Diagnoses)". I welcome others' thoughts.