Oncology & Hematology Coding Alert

Question: Which diagnosis code is appropriate for malfunctioning of a Port-a-Cath? Is it a V code?

New York Subscriber

Answer: The proper code depends on the specific complication or malfunction type, so you would need more information to choose the best code.

Typically, youll choose a complication code from the following options:

" 996.1 -- Mechanical complication of other vascular device, implant, and graft

" 996.62 -- Infection and inflammatory reaction due to internal prosthetic device, implant, and graft; due to other vascular device, implant, and graft (requires an additional code to specify the infection, such as sepsis)

" 996.74 -- Other complications of internal (biological) (synthetic) prosthetic device, implant, and graft; due to other vascular device, implant, and graft

" 999.31 -- Infection due to central venous catheter (requires an additional code to specify the infection, such as sepsis).

Once youve chosen the appropriate primary code,you should report E878.8 (Other specified surgical operations or procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at the time of operation) as a secondary code on the claim.

The device: A physician places a Port-a-Cath under the chests skin and inserts the catheter into the superior vena cava. The nurse can feel the Port-a-Caths edges under the skin, and she inserts a special needle (you may see it documented as a Huber needle) in the middle. Providers may administer chemotherapy, draw blood, or both through the Port-a-Cath.