Internal Medicine Coding Alert

Question: I report V58.69 (Long-term [current] use of other medications) when the physician performs monitoring or orders lab tests for various medications that require frequent rechecks. For instance, Zocor and Lipitor will often require liver testing, so I report V58.69 and the pertinent diagnosis, 272.4 (Other and unspecified hyperlipidemia). But I can't really find any detailed explanation regarding when it's appropriate to use V58.69. All my ICD-9 manual says is "high-risk medications." Where is there a definition for high-risk medications?


Kentucky Subscriber


Answer: Codes in the V58.6x (Long-term [current] drug use) subcategory are status codes that state only that a patient is on a drug for an extended period. There is no specific listing of these medications.

According to Chapter 18 of the ICD-9-CM Guidelines (Section 1C), "Assign a code from subcategory V58.6, Long-term (current) drug use, if the patient is receiving a medication for an extended period as a prophylactic measure (such as for the prevention of deep vein thrombosis) or as treatment of a chronic condition (such as arthritis) or a disease requiring a lengthy course of treatment (such as cancer). Do not assign a code from subcategory V58.6 for medication being administered for a brief period of time to treat an acute illness or injury (such as a course of antibiotics to treat acute bronchitis)."