# V58.69 - I have alway used DX code



## aoglesby (Feb 21, 2013)

I have alway used DX code V58.69 to all lab charges that we bill. I just received my first denial stating that you can not use that code as a primary dx. I can not find any where in the ICD-9 Book that states it must be use as a secondary dx. Can any one help me with this issue. If it is documented in the book. Please tell me what page it is on.


----------



## mitchellde (Feb 21, 2013)

It is not in the code book.. It was designated as secondary only in 2004 and was listed in the AHA Coding  Clinic 4thQ 2004 as secondary only.  It is a status code indication only that the patient is on a high risk med, for lab draws you need the reason for the test.  If the reason if to check drug levels for therapeutic valuse then you use V58.83 first and the V58.6x second.
but why do you use V58.69 always?  there are V58.6x codes specific to many types of drugs, use the V58.69 only if the drug you are testing for is not listed among the choices.


----------



## traci.susong@gmail.com (Apr 18, 2013)

*v58.69*

Patient is on chemo and had 84439 & 84443 labs drawn as part of the chemotherapy treatment protocol (Free Thryoxin and TSH) for ipilimumab. Is V58.69 the correct code to justify the lab tests?


----------



## mitchellde (Apr 18, 2013)

use V58.83 first and then the V58.69


----------



## traci.susong@gmail.com (Apr 19, 2013)

Would this also apply to when the doctors order PT/INR while on chemo as this effects their bleeding and coagulation? 

Thanks.


----------



## mitchellde (Apr 19, 2013)

yes it will be the same you are monitoring for any effects of the chemo


----------

