Oncology & Hematology Coding Alert

Question: Should I report a V code as primary for every encounter that includes chemotherapy?

Utah Subscriber

Answer: The ICD-9 official guidelines indicate that if a patient admission/encounter is solely for the administration of chemotherapy, immunotherapy, or radiation therapy, assign the appropriate V58.x code as the first-listed or principal diagnosis, and the diagnosis or problem for which the service is being performed as a secondary diagnosis.

If the patient presents for chemotherapy and develops complications such as dehydration, you should report the treatment encounter code (V58.11, Encounter for antineoplastic chemotherapy) first, as well.

However, in other instances, the neoplasm treated becomes the principal diagnosis. For example, if the patient presents to determine the extent of the malignancy or have a procedure, such as paracentesis or thoracentesis, the malignancy is first-listed even if the patient receives chemotherapy the same day.

Resource: You can download the official ICD-9 guidelines at www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/ftpicd9.htm.

-- Technical and coding advice for You Be the Coder and Reader Questions provided by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and past president of the AAPC National Advisory Board.