Ringed Sideroblasts

71 years old female. Breast CA diagnosed in 1972 (after changing status of mastectomy, who returned in '73 and was treated with chemo.1989 noted to be anemic. Suffered a bone marrow biopsy compatible with myelodysplastic syndrome of unknown type. Patient Today the clinic hematology prsesnted today (weakness, fatigue, SOB. H & H 3.4 and 10.5 respectively. admitted for blood transfusion. orthostatic patient. Problem 1) myelodysplastic syndrome and bone marrow failure. blood type and cross-matched transfusion because of hx and the patient has antibodies against antigens of the built RHE. Problem 2) A fluid overload. Problem 3) refractory anemia with ring sideroblasts.I coded for MDS, do I also fault code of the bone marrow? or is it just a symptom of MDS? I coded for fluid overload and and refractory anemia with ringed sideroblasts. I also encoded the blood under the procedures. Do I need to code for the status after mastectomy (which I can not find a code for) and chemo? I think I should code, because the chemo past likely contributed to anemia. But they really are not listed as a problem for this visit! Finally, do I code for the type and the Cross through the procedures and do I code the fact that she is Rh negative? Thank you!

The best advice is to call a regular nurse announces that on here.