# Contact to Methotrexate



## VRMoran (May 25, 2011)

I have a patient that is at 14 wk which had contact to Methotrexate at work. I am leaning to V87.39 and E866.8 or E850.6 as my diagnosis codes.  Does anyone have anyother thoughts


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## preserene (May 29, 2011)

" Contact" with Methotroxate ?
Well, I would like to know whether you are talking about just " Contact" with the drug or "ADMINISTRATION" of the drug. I have not come across any side effects being reported with just coming in contact (touch) so far. 
Verify with your Provider as to what sort of contact the patient had or administration of the drug and the side effects (s)he has/or could document.

Administration of Methotroxate (eg, oral or parenteral) has got side effects/birth defects/ teratogenic effect on the fetus, even if you take before pregnancy or during pregnancy or during lactation.

Methotroxate is an antimetabolite. It works to treat cancer and psoriasis by blocking an enzyme needed for cell growth. This helps to slow the growth of cancer cells and abnormal skin cells. Exactly how Rheumatrex works to treat rheumatoid arthritis is unknown. It reduces symptoms of inflammation (eg, pain, swelling, stiffness) caused by rheumatoid arthritis.

It has been and being used successfully for termination of Tubal Pregnancy (ECTOPIC PREGNANCY)

Methotroxate may cause birth defects or fetal death. Do not use Rheumatrex to treat psoriasis or rheumatoid arthritis if you are pregnant. Consult the doctor before you take Rheumatrex if you are pregnant or think you may be pregnant.
 Do not become pregnant while using Rheumatrex. Talk to your doctor about using an effective form of birth control.
Women of childbearing potential should not be started on MTX until pregnancy is excluded and should be fully counseled on the serious risk to the fetus should they become pregnant during treatment.
*Pregnancy should be avoided if either partner is receiving MTX, during and for a minimum of 3 months after therapy for male patients, and during and for at least 1 ovulatory cycle for female patients. *This drug has been successfully used to terminate tubal pregnancy. MTX is contraindicated in pregnant patients with psoriasis or rheumatoid arthritis and should be used in the treatment of neoplastic diseases only when the potential benefit outweighs the risk to the fetus.

My advice is to query with and get more specific information from your provider as regards to administration and the period used, the symptoms & signs because of that and if you have doubt still kindly post the full inforamation.

If the patient just came for the fear of having "contacted"(by touch) the drug and the doctor evaluated  for any specific side effects and FOUND NOT ANY SIDE EFFECT, THEN YOU CAN GO FOR V 71 SERIES AS YOUR PRIMARY DIAGNOSIS.
Hope this hepls a bit.

Thank you


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## Mojo (May 29, 2011)

I agree with Preserene, we need more information. It seems a Chapter 11 Complications of Pregnancy code which takes sequencing priority should be included. I doubt if this is the case, but should the provider document that the encounter is incidental to the pregnancy, code V22.2.


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