Oncology & Hematology Coding Alert

Question: Which diagnosis codes should we use when a patient presents for external beam radiation therapy directed at a malignant neoplasm of the middle lobe of the lung? The documentation shows that the treatment is palliative--aimed at alleviating breathing problems caused by the tumor.


Kansas Subscriber


Answer: Depending on your payer guidelines, your claim should include:

- V58.0--Encounter for radiotherapy

- 162.4--Malignant neoplasm of trachea, bronchus, and lung; middle lobe, bronchus, or lung

- V66.7--Encounter for palliative care

- any documented symptoms, such as 786.05 (Shortness of breath).

According to American Hospital Association guidance, you should report the underlying disease before reporting palliative care.

If the patient has a secondary malignancy, consider reporting it as well, to show the extent of the disease process.