Wiki Port Flush - appropriate diagnosis code

[JAC72]

I am not sure what the appropriate diagnosis code would be for a patient who has not received any chemotherapy since June 2012 but still has a port and comes in every 6 weeks to have the port flushed with Heparin. The patient comes in every 3 months for follow up visits with the Oncologist also (as he wants to see her every 3 months for 2 years). I noticed that the port flushes and the follow up visits are being coded with the cancer diagnosis. It is my understanding that you only code the cancer diagnosis if the patient is currently receiving treatment. I know the follow up visits should be coded with history of cancer but what diagnosis should the port flushes be coded? V58.81? I am looking into why the patient still has a port.

Thanks for the help.

 

[rcrouch@crmchealth.org]

Re: port flushes

I work in a hospital owned cancer center and we do lots of port flushes. Since it does require a surgical procedure to remove the port-a-cath, most patients do not have them removed unless there is a problem with the port-a-cath or the patient developes an infection.

We code this with either the cancer code or a history of cancer along with the V58.81. We have not had any problems getting these paid.

As far as the cancer dx code, our doctors do not like to use the "history of" as long as they are in follow-up. I know that there is a lot of discussion about when is it history. Most coding authorities say when the cancer has been totally removed/eradicated or when the patient is no longer in active treatment. One of our doctors states that you never really know that the cancer is eradicated, that is why patients come back and have metastasis.

rcrouch