III.3.14 Comorbidities and Complications

Comorbidities and Complications data fields 1-10 are designated to capture the patient's preexisting medical conditions, factors influencing health status, and/or complications during the patient's admission to the reporting facility for the treatment of the cancer using ICD-9-CM codes. These factors may affect treatment decisions and influence outcomes.

NOTE: ICD-10-CM was implemented October 1, 2015.

Coding Instructions:

ONLY ICD-9-CM codes are allowed in this field. ICD-10-CM codes are to be coded in the data item Secondary Diagnosis 1-10. During the adoption of ICD-10-CM codes, it is possible both will appear in the same patient record.

Although data collection for these fields is required by the CCR if available, Comorbidity/Complications 1-10 will be collected from CoC facilities.

If a comorbid condition is stated in the medical record but is not coded, do not attempt to code the condition in ICD-9-CM or ICD-10-CM.

EXAMPLE: If diabetes is mentioned in the medical record and it is not coded in the medical record do not attempt to code the condition in ICD-10-CM or fill in these fields.

Code the comorbid conditions in the sequence in which they appear in the discharge summary or recorded by the billing department.

Report the comorbid conditions for this cancer using the following priority rules:

Surgically treated patients:

Following the most definitive surgery of the primary site
Following other non-primary site surgeries

Non-surgically treated patients:

Following the first treatment encounter/episode

In cases of non-treatment:

Following the last diagnostic/evaluative encounter

If no ICD-9-CM comorbid conditions were documented, then code 00000 in the field Comorbidities and Complications #1 and leave the remaining fields blank.

If fewer than 10 ICD-9-CM comorbid conditions are listed, then code the diagnoses listed, and leave the remaining fields blank.

For further information, please refer to the current FORDS Manual.

Note: For comorbid conditions (ICD-9-CM codes 00100-13980 and 24000-99990), there is an assumed decimal point between the third and fourth characters. For complications (ICD-9-CM codes E8700-E8799 and E9300-E9499), there is an assumed decimal point between the fourth and fifth characters. For conditions influencing health status and contact with health services (ICD-9-CM codes V0720-V0739, V1000-V1590, V2220- V2310, V2540, V4400-V4589, and V5041-V5049), there is an assumed decimal point between the third and fourth characters. For ICD-10-CM codes there is an assumed decimal between the third and fourth characters.