Wiki Diagnosis for Prophylatic

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coding?4u

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I have some inpatients receiving prophylatic treatment for nausea-cancer patients and others given this treatment to prevent DVT. I code the E&M
based on the #of problems-new, estab, worsening etc. I do not have a code for the above, so I don't code it. I am told that I am not coding my levels high enough as I am leaving codes off. I dont' see an ICD 9 code for the prevention of something. Would I use a V code and count it as a new problem?
If you are admitted for a new round of chemo, this is established and I have one diag, low for an admisson. I am told since prophylatic nausea, I should count this as a problem as well. Therefore I can raise the level higher.
Need help please!
 
Thanks. How would you code this then? Would you use for example
V58.61, 162.9 Lung Ca, and then your V code per above on the claim
but only count the 162.9 as an estab. problem and code the service as
99221. The Chemo and Proph would be counted under the risk? Or would you give credit to the prophylatic under "number or diag/managment options
as a self limited or minor problem? This could bring the level to 99222.
I hope this makes sense.
 
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