Advanced Search

Oncology & Hematology Coding Alert

READER QUESTION ~ Prevent Denials for Prophylactic Treatment

Published on Tue Feb 20, 2007

Question: I-m new to oncology coding and am having trouble coding a report involving radiation therapy to a site the doctor thinks the primary neoplasm may spread to. That is, there's now no sign the primary neoplasm metastasized, but the doctor wanted to treat the potential problem area prophylactically. What diagnosis codes should I submit in this situation?

New York Subscriber Answer: First report V07.8 (Other specified prophylactic measure) to indicate that the service is prophylactic. Then report the diagnosis code representing the site of the primary neoplasm.

Example: The doctor wants to take action against allowing a patient's colon cancer from spreading, and the patient receives prophylactic radiation. Report V07.8 first and then the code for the primary tumor, such as 153.1 (Malignant neoplasm of colon; transverse colon).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Oncology & Hematology Coding Alert

View All