Oncology & Hematology Coding Alert

Question: Which CPT®, ICD-9, and HCPCS codes should I use for a 100.2 mg doxorubicin IV push for a patient receiving palliative chemotherapy for advanced adrenal cortical cancer? The patient did not respond to mitotane.

Minnesota Subscriber

Answer: Your diagnosis codes should include the following:

• V58.11, Encounter for antineoplastic chemotherapy
• 194.0, Malignant neoplasm of adrenal gland
• V66.7, Encounter for palliative care.

Remember that the point of palliative treatment is to relieve the symptoms of the disease, improving quality of life, rather than curing the illness. If the physician documents the symptom/issue the palliative treatment is intended to relieve, consider reporting a code for that condition as well to help support medical necessity. (This also can be an important factor in facility settings and could affect reimbursement in some cases.)

To report the administration of doxorubicin, assign 96409 (Chemotherapy administration; intravenous, push technique, single or initial substance/drug). This code applies because doxorubicin is a chemotherapy drug, and you specify the drug was given as an intravenous push.

Report the drug using J9000 (Injection, doxorubicin hydrochloride, 10 mg). Claim 11 units to represent the 100.2 mg administered. (Remember that there is a separate code for lipid formulations: J9001, Injection, doxorubicin hydrochloride, all lipid formulations, 10 mg.)

Tip: Be sure to watch for reportable administration of pre-meds, as well, such as anti-emetics.