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#1
06-09-2010, 01:48 PM
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chemotherapy
Patient has a hx of breast cancer, she is clear from cancer for 2 years, she comes in for a routine f/u and found that the cancer spread to the lymph node.
How would you code for the chemo treatment do you code use V58.11, 174.9, 196.9 or v58.11, 196.9, V10.3? thank you. 
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#2
06-09-2010, 05:53 PM
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You would code the chemo admin first then the metastatic cancer code then the hx of breast cancer. The primary site is still free of disease, the cells moved to a new organ.
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Debra A. Mitchell, MSPH, CPC-H 
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#5
06-11-2010, 08:06 AM
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Look at the coding guidelines if the reason for the encounter is chemo then V58.11 is required to be first listed. AHA coding clinics have stated on many occasions that you the cancer being treated next and if it is a metastatic cancer then you always list the primary also, and it can be active, hx of , or unknown. If there is no evidence of disease at the primary site and there is no residual tx being directed to the primary site then it is hx of and MUST be coded that way. We must remember that the dx is the patient's and not the carriers and we have a duty to code it as documented by the physician to acurately capture the patient's condition for data collection. The carrier cannot tell us what the patient's dx is.
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Debra A. Mitchell, MSPH, CPC-H
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#7
06-22-2010, 02:14 PM
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Is it possible that the drugs being given are not chemotherapy? If so that is fine for instance BRM drugs would not be coded as V58.11. But if the reason for the encouner is for the administration of chemo then you must use the V58.11 code.
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Debra A. Mitchell, MSPH, CPC-H
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#9
07-06-2010, 03:02 PM
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That is correct.
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Debra A. Mitchell, MSPH, CPC-H
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#10
08-13-2010, 06:39 PM
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[quote=mitchellde;115392]Is it possible that the drugs being given are not chemotherapy? If so that is fine for instance BRM drugs would not be coded as V58.11. But if the reason for the encouner is for the administration of chemo then you must use the V58.11 code.[/QUOTE
Hi Debra, I wanted to see if you know where I could get a quick reference to decipher if the drugs listed within the body of the progress notes are for chemo or not? I am having some difficulty deciphering the MDM on my encounters. I am very new to oncology coding and there is alot I need to learn. Thanks in advance,
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Roxanne Thames, CPC, CEMC AAPCCA Board of Directors 2012-2015 Region 1- ME, NH, VT, MA, RI, CT, NY Past President 2011, 2012 York, PA Chapter Past President Elect 2010 York, Pa Chapter Roxanne.Thames@aapcca.org
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