Oncology & Hematology Coding Alert
Document These Encounter Codes for Hormone Therapy
Question: When a patient presents to our practice for hormone therapy injections to treat breast or prostate cancer, the service is charged in our system as chemotherapy, which I have coded using Z51.11 in the past without issue. However, I am not sure if this is correct code choice. What code is the best to represent this service? AAPC Forum Participant Answer: The role of hormone therapy in cancer treatment is to block or stop hormone activity in order to reduce or stop cancer cells that grow on those hormones. As the purpose of the therapy is not to replace hormones in the patient but is directed at the cancer, you cannot use Z79.890 (Hormone replacement therapy). Even though hormone therapy is neither chemotherapy nor immunotherapy, your best bet in these situations is to use a diagnosis code for the condition your provider is treating. This will support the medical necessity of the hormone therapy. Use either Z51.11 (Encounter for antineoplastic chemotherapy) or Z51.12 (Encounter for antineoplastic immunotherapy) and assign a code for the condition being treated as applicable is necessary.
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Document These Encounter Codes for Hormone Therapy
Question: When a patient presents to our practice for hormone therapy injections to treat breast [...]
