# Z51.11 - to drop or not to drop...



## aimeeread (Jan 15, 2016)

Hello,

I have a question as to whether or not you drop the Z code while the patient isn't receiving treatment...

For example, if a patient is admitted on 1/1 for induction of chemotherapy, finishes treatment on 1/8, remains in the hospital and has repeat biopsy on 1/14, repeat biopsy shows residual disease and it's determined that patient is going to do another induction chemo treatment starting immediately, they remain hospitalized and do 5 more days of chemo...

Question: Do you drop the Z code on 1/9-1/14? And, if so, do you pick it back up when they decided to reinduce treatment again?

I know that the Z code is primary upon admission, but does that mean for the entire stay whether the focus changes or not?

Thanks in advance for any input!


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## KMayercsik (Jan 19, 2016)

*Z51.*

I read guidelines that state "when the purpose of the encounter is to deliver antineoplastic chemotherapy" then the Z51.11 is the primary diagnosis.
You should assign secondary diagnosis codes for the cancer and for any complications that result during that encounter from the chemo. However,  if the purpose of the admission or encounter is surgical treatment, to determine the extent of the cancer, or to perform a procedure such as paracentesis or thoracentesis, and the patient also receives radiation or chemo, you should code the cancer as the primary diagnosis. 
Hope this helps.  
Karen Mayercsik, CPC, CHAM


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