Oncology & Hematology Coding Alert

Question: Our head and neck cancer patients often have dry mouth due to radiation treatment, and we treat them with amifostine. Is there any diagnosis code that proves medical necessity for this service?


Texas Subscriber
Answer: You-ll have to check with your specific payer, but here are some possibilities you can try as your primary diagnosis:

- V58.0--Radiotherapy
- V58.11--Encounter for antineoplastic chemotherapy
- 527.7--Disturbance of salivary secretion
- 909.2--Late effect of radiation
- 909.5--Late effect of adverse effect of drug, medical, or biological substance
- 990--Effects of radiation, unspecified
- 995.2--Unspecified adverse effect of drug, medicinal, and biological substance. You should report the neoplasm as the secondary diagnosis.

Radiation therapy may damage salivary glands and cause dry mouth (xerostomia) in head and neck cancer patients. Amifostine helps protect normal salivary gland cells from the effects of radiation.

Payers may consider amifostine medically necessary when the radiation port includes a large portion of the parotid glands. The answers for You Be the Coder and Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and president, AAPC National Advisory Board.