Oncology & Hematology Coding Alert

Immunotherapy finds a similarly clear counterpart in the new code set.

The ICD-9-CM code for a chemotherapy encounter, V58.11, may be one of your most used codes. But when ICD-10-CM becomes your new diagnosis code set in 2013, you'll have a new top code. Here are a few tips to help ease the way.

ICD-9-CM: Under ICD-9-CM 2012, your first-listed code when a patient presents solely for antineoplastic chemotherapy is V58.11 (Encounter for antineoplastic chemotherapy).

You choose a different code to indicate a visit for antineoplastic immunotherapy: V58.12 (Encounter for immunotherapy for neoplastic condition).

ICD-10-CM: The 2012 ICD-10-CM code set replaces V58.11 with Z51.11 (Encounter for antineoplastic chemotherapy).

The code that crosses to immunotherapy code V58.12 is Z51.12 (Encounter for antineoplastic immunotherapy).

Coder tip: Under both ICD-9-CM and ICD-10-CM official guidelines, you should report the code for the neoplasm being treated following the encounter code. Both sets also include an instruction that you should not use these encounter codes if the patient presents for chemotherapy or immunotherapy for a non-neoplastic condition. In those situations, you should code the specific condition being treated.

Remember: When ICD-10-CM goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.