Question: “What is the best code for elevated D-dimer test?”
Answer: Currently there is no official determination as to the best code for this test. 790.6, other abnormal blood chemistry, relates to chemicals/elements in the blood such as cobalt, copper, iron or lead and does not apply. Some coders like 790.92, abnormal coagulation profile. However, the D-dimer test looks for the breakdown of clots, rather than coagulation. Therefore, 790.99, other nonspecific findings on examination of blood, is recommended. The D-dimer test measures the levels of dextro dimer fragments in the blood. This can alert the physician to the presence of venous thromboembolisms. Venous thromboembolisms include both deep venous thromboses and also pulmonary embolisms.
Jane Barta, RHIA, RMC Coding Consultant
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I asked my cohorts about Jane’s post and Marcia, a Director with RMC, agrees. Marcia commented, “I agree with the information that Jane has written. I also have information from the University of Texas Medical Branch Laboratory Test Directory stating that the D-Dimer test detects elevated levels of cross-linked fibrin derivatives associated with disseminated intravascular coagulations(DIC), deep vein thrombosis, pulmonary embolism, and other thrombotic conditions. Also been reported in the post-operative period, cancers, hemorrhages, and severe infections. So to me the best code would be the 790.99 code.”