# diagnosis question -  radiologist mentions "needs venous access



## conniff (Nov 12, 2008)

Hello, 
  radiologist mentions "needs venous access for antibiotics".  This is for a piccline placement.  Could you use a v-code like v58.81, fitting and adjustment of vascular cath, (or other v-code) or would you try to get more clarification??
     thanks


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## kevbshields (Nov 13, 2008)

Actually, I'd do both:  V58.81 describes your reason for the encounter.  Since there's probably an underlying infection, I'd ask what that was to code as a secondary code.


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## Shirleybala (Nov 18, 2008)

conniff said:


> Hello,
> radiologist mentions "needs venous access for antibiotics".  This is for a piccline placement.  Could you use a v-code like v58.81, fitting and adjustment of vascular cath, (or other v-code) or would you try to get more clarification??
> thanks



The V code for "needs venous access for antibiotics".  is V58.62 as a secondary diagnosis


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## Anna Weaver (Nov 19, 2008)

*diagnosis question*



Shirleybala said:


> The V code for "needs venous access for antibiotics".  is V58.62 as a secondary diagnosis



This leads me to a question, would you code the V58.62 if they haven't started the antibiotic yet? I was always under the impression these V codes were for medications they had already started and were using long term and not something used until they had started and not something used for short term (I know if they put in an IV it will be long term).


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## pharmon (Nov 19, 2008)

I use v58.81 for any PICC or CVP placements, I never add why it's done.  We haven't had problems being paid on these with just V-codes.


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## magnolia1 (Nov 19, 2008)

My understanding of V58.81 is that this code is used for the removal or replacement of a previously placed vascular catheter.

As in the case of a Port-A-Cath placement for Chemo, the principal dx is the the "malignancy" code. I would query the radiologist for the reason for the venous access.


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## kevbshields (Nov 19, 2008)

Not so on V58.81 being used only for replacements or repositionings.  A "fitting" (as noted in the code title) would also be included.  A fitting is typically defined as an initial encounter to establish use or practice of a medical item.  Therefore, V58.81 for an initial encounter of placement of the PICC satisfies the code descriptor.

As for V58.62, _AHA Coding Clinic_ only uses contexts related to present, long-term use of the antiobiotic--not any for future or presumed use.  The code for the condition necessitating the antiobiotics (if possible to find) would be appropriate for use.


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## AnthonyBush (Nov 21, 2008)

This may be a bit late to jump in on this conversation.  But here goes.  The GUIDELINES for this code V58.6X are as follows:
Section I.C.18.d.3 
Codes from this subcategory (v58.6) indicate a patients continuous use of a prescribed drug for the long-term treatment of a condition or for prophylactic use.  It is not for use for patients who have addictions to drugs.
Assign a code from subcategory V58.6, *if the patient is receiving a medication for and extended period as a prophylactic measure or as treatment of a chronic condition or a disease requiring lengthy course of treatment. * Do not assign a code from subcategory V58.6 for medication being administered for a brief period of time to treat and acute illness or injury(such as a course of antibiotics to treat acute bronchitis).


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