M31.11
Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA]
Clinical Classification Guidelines
Use Additional Code
- code to identify specific organ dysfunction, such as:
- acute kidney failure (N17.-)
- acute respiratory distress syndrome (J80)
- capillary leak syndrome (I78.8)
- diffuse alveolar hemorrhage (R04.89)
- encephalopathy (metabolic) (septic) (G93.41)
- fluid overload, unspecified (E87.70)
- graft versus host disease (D89.81-)
- hemolytic uremic syndrome (D59.3-)
- hepatic failure (K72.-)
- hepatic veno-occlusive disease (K76.5)
- idiopathic interstitial pneumonia (J84.11-)
- sinusoidal obstruction syndrome (K76.5)
Inclusion Terms
- Transplant-associated thrombotic microangiopathy [TA-TMA]
Code First
- if applicable:
- complications of bone marrow transplant (T86.0-)
- complications of stem cell transplant (T86.5)
Medical Intelligence & Overview
Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a rare but serious complication that can occur after a stem cell transplant. It involves damage to small blood vessels, which can impair blood flow and lead to organ issues. This condition requires prompt recognition and management to prevent severe health problems. In this guide, we'll explore what HSCT-TMA is, its causes, symptoms, diagnosis, and general approaches to treatment.
Causes & Symptoms
Clinical Causes: Damage to blood vessel linings caused by the transplant procedure Use of certain medications that increase risk, such as calcineurin inhibitors Infections that can trigger vascular injury Graft-versus-host disease (GVHD), a condition where transplanted cells attack the recipient's tissues Pre-existing health conditions that may predispose to microvascular damage
Key Symptoms: Signs of anemia such as fatigue, weakness, or pallor Bleeding tendencies or easy bruising Decreased urine output or blood in the urine Swelling or fluid retention, especially in the legs and ankles High blood pressure Fever or signs of infection Organ dysfunction, which might manifest as confusion or decreased kidney function
Diagnostic & Treatment
Diagnosis Path: Diagnosing HSCT-TMA involves a combination of clinical evaluation and laboratory tests. Healthcare providers look for signs of hemolytic anemia, evidence of blood vessel damage, and organ involvement. Blood tests may reveal low platelet counts, anemia, elevated lactate dehydrogenase (LDH), and schistocytes (fragmented red blood cells). Kidney function tests and urine analysis help assess renal involvement. Sometimes, tissue biopsies are performed to confirm small vessel damage.
Treatment Protocols: While specific management depends on the patient's condition, general approaches can include:
Clinical Advice & FAQs
Billing Guidance
Is M31.11 a billable ICD-10 code?
Yes, M31.11 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report M31.11?
Clinical documentation must specify the nature of Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA] and any associated comorbidities for accurate reporting.
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