Oncology & Hematology Coding Alert

Question: The November issue of Oncology Coding Alert described two new encounter codes--V58.11 and V58.12. Would you provide more details on when it's appropriate to use these codes?


California Subscriber
Answer: The 2006 ICD-9 codes, which went into effect Oct. 1, 2005, included V58.11 (Encounter for antineoplastic chemotherapy) and V58.12 (Encounter for antineoplastic immunotherapy).

ICD-9 2006 also includes the new instruction that you should -code to condition for chemotherapy and immunotherapy for non-neoplastic conditions- instead of using a V58.1x code. You also shouldn't use these codes for prophylactic chemotherapy described by codes V03.0-V07.9.

These new codes are more specific than the code you previously used for these encounters--V58.1 (Encounter for chemotherapy). The motivation for the new code is the ability to track outcome data for immunotherapy patients.

Immunotherapy stimulates the body's ability to fight disease, as opposed to chemotherapy, which attacks cancer cells. Immunotherapies used against cancer include interferon-alfa (IFN-alfa) for certain leukemias and lymphomas, and interleukin-2 (IL-2) for renal cell carcinoma and malignant melanomas. Refer to individual payer guidelines for a complete list of drugs that qualify for immunotherapy.