Wiki Labs and Rituxan

[MACK]

The question comes up all the time when we have a new patient starting on Rituxan.
The labs need to be drawn prior to therapy to check for hepatitis.
They have not started nor have been on therapy. The patients seem to have denials for
the hepatitis labs being drawn.. If anyone has any other ideas.

Here are the choices they are currently using:

V58.11 Encounter For Antineoplastic Chemotherapy
V58.12 Encounter For Immunotherapy For Neoplastic Condition
V67.51 Follow-up Examination, Following Completed Treatment With High-risk Medication, Not Elsewhere Classified

medication, not elsewhere classified
Excludes: long-term (current) drug use (V58.61-V58.69)

 

[rcoslett]

one more code to try

I would try 573.3 Hepatitis, drug induced
and, it's a covered code for CMS!
Keep us posted

 

[davidsnk]

Sorry but in this case, do not use 573.3 - Hepatitis, drug induced.

This code is for a patient that has a diagnosis of hepatitis. As I understand it, you are just testing prior to Rituxan to make sure the patient doesn't have liver disease, correct?

I don't have a definant answer for you as I don't code laboratory services, but this code might work....

995.20-Unspecified adverse effect of drug, medicinal and biological substance properly administered.

 

[mitchellde]

no you would not use the 995.20 for the same reason you would not use 573.3 they do not have hepatitis nor have they experienced an adverse effect as of yet.
we always use the cancer diagnosis and if they have been on chemo we use the V58.69 as a secondary or if they have just finished radiation we use the V 67 code for followup following radiation.