Oncology & Hematology Coding Alert

Question: Which administration code is appropriate for Dacogen?

Nevada Subscriber

Answer: You should verify your payer’s preference, but you’ll typically see chemotherapy administration codes advised for use with Dacogen.

For instance, if the nurse administers 36 mg of Dacogen over one hour, you may report 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug) for the hour of administration. You also should report the Dacogen supply using 36 units of J0894 (Injection, decitabine, 1 mg).

Your ICD-9 coding will depend on the documentation, but diagnoses you may see include the following:

238.72, Low grade myelodysplastic syndrome lesions

238.73, High grade myelodysplastic syndrome lesions

238.74, Myelodysplastic syndrome with 5q deletion

238.75, Myelodysplastic syndrome, unspecified.

Expect many of your ICD-10-CM coding options for these diagnoses to use terminology other than myelodysplastic, as shown below. The ICD-9-CM cross codes are shown in parentheses:

D46.0, Refractory anemia without ring sideroblasts, so stated (238.72)

D46.1, Refractory anemia with ring sideroblasts (238.72)

D46.20, Refractory anemia with excess of blasts, unspecified (238.72)

D46.21, Refractory anemia with excess of blasts 1 (238.72)

D46.22, Refractory anemia with excess of blasts 2 (238.73)

D46.4, Refractory anemia, unspecified (238.72)

D46.9, Myelodysplastic syndrome, unspecified (238.75)

D46.A, Refractory cytopenia with multilineage dysplasia (238.72)

D46.B, Refractory cytopenia with multilineage dysplasia and ring sideroblasts (238.72)

D46.C, Myelodysplastic syndrome with isolated del (5q) chromosomal abnormality (238.74)

D46.Z, Other myelodysplastic syndromes (238.75).