Oncology & Hematology Coding Alert

Question: A patient who is on chemotherapy treatment for lymphoma, presents for a weekly injection of darbepoetin alfa. The patient was documented to receive 500 mcg of Aranesp subcutaneously. How can we report this service?

Answer: From the description provided, it is evident that the patient reports for darbepoetin alfa injection. Darbepoetin alfa (Aranesp®) is an erythrocyte stimulating agent and not chemotherapy. So for this subcutaneous injection, submit HCPCS code 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular).

Since the patient receives darbepoetin alfa for chemotherapy induced anemia, you submit the HCPCS level II code J0881 (Injection, darbepoetin alfa, 1 microgram [non-ESRD use]). Report one unit of code J0881 for each mcg of darbepoetin alfa administered, i.e. 500 units of J0881.

Darbepoetin alfa: Darbepoetin alfa is a form of a protein that works to produce red blood cells in the body. Providers use darbepoetin alfa to treat anemia.

Diagnosis code: For anemia due to chemotherapy, you submit ICD-10 code D64.81 (Anemia due to antineoplastic chemotherapy). Since the encounter was for treatment of anemia, your first diagnosis remains chemotherapy induced anemia. The patient has developed anemia secondary to chemotherapy used in the treatment of lymphoma.

There is no site specified in the question to differentiate the lymphoma and underlying malignancy in the patient. For unspecified site of lymphoma, you submit ICD- 10-CM code C85.10 (Unspecified B-cell lymphoma, unspecified site). If a more specific type of lymphoma is supported, check the ICD-10-CM series C82.50 (Diffuse follicle center lymphoma, unspecified site) to C86.4 (Blastic NK-cell lymphoma) for a more definitive code.