Refractory anemia with excess of blasts [RAEB]
ICD-10 D46.2 is a billable code used to indicate a diagnosis of refractory anemia with excess of blasts [raeb].
Refractory anemia with excess of blasts (RAEB) is a subtype of myelodysplastic syndromes (MDS) characterized by ineffective hematopoiesis and the presence of increased numbers of myeloid blasts in the bone marrow and peripheral blood. Patients with RAEB typically present with symptoms of anemia, such as fatigue, pallor, and weakness, alongside signs of cytopenias, which may include thrombocytopenia and leukopenia. The diagnosis is confirmed through bone marrow biopsy, which reveals dysplastic changes and an increased blast percentage, typically ranging from 5% to 19%. RAEB is considered a precursor to acute myeloid leukemia (AML), and its management often involves supportive care, such as transfusions and growth factors, as well as potential disease-modifying therapies like hypomethylating agents. Due to its potential for progression to AML, patients require careful monitoring and follow-up, making surveillance critical in the management of this condition.
Comprehensive documentation of blood counts, bone marrow biopsy results, and treatment plans.
Patients presenting with fatigue and cytopenias requiring evaluation for MDS.
Ensure accurate recording of blast percentages and any treatment responses.
Detailed treatment history, including chemotherapy regimens and response assessments.
Patients transitioning from MDS to AML requiring aggressive treatment.
Monitor for signs of progression and document any changes in treatment strategy.
Used to monitor blood counts in patients with RAEB.
Document all blood count results and any significant changes.
Hematologists should ensure that CBC results are correlated with clinical findings.
The blast percentage is crucial in determining the severity of RAEB and the risk of progression to acute myeloid leukemia. Accurate documentation of this percentage is essential for appropriate coding and treatment planning.
