Prophylactic radiation therapy

Messages
1
Best answers
0
We are having difficulties with the proper ICD 10 coding for prophylactic radiation therapy. We have two different scenerios: 1) if patient is having prophylactic brain therapy due to lung cancer and 2) prophylactic radiation to prevent heterotopic ossification following a total hip replacement due to osteoarthritis. Any help would be greatly appreciated along with the reference in which the coding scenerio is cited. Thanks so much.
 

KMayercsik

Networker
Messages
51
Best answers
0
PCI/Hetero bone

We are having difficulties with the proper ICD 10 coding for prophylactic radiation therapy. We have two different scenerios: 1) if patient is having prophylactic brain therapy due to lung cancer Z41.8
and 2) prophylactic radiation to prevent heterotopic ossification following a total hip replacement due to osteoarthritis. M96.89

Any help would be greatly appreciated along with the reference in which the coding scenerio is cited. Thanks so much.
 

mitchellde

True Blue
Messages
13,505
Location
Columbia, MO
Best answers
2
I disagree with the answer to the number 2 scenario.. There is no complication of the surgery documented in the statement. The treatment is prophylactic to prevent a complication. The code is the same Z41.8. As the reason for the treatment in s essentially the same in both cases.
 

mgonzale9658

Guest
Messages
2
Best answers
0
Pci

I am having the same problem w/PCI. Medicare denied due to the coder using dx Z41.8. I believe we require the primary diagnosis C34.11 however the coders are telling that is incorrect and I need to appeal. I am now being told by another member we can not use Z41.8 we need to recode to Z29.8 as prim and C34.11 as the secondary diagnosis. I believe this is incorrect. Can someone please help?
 

neddins

New
Messages
1
Location
Mobile, Alabama
Best answers
0
I am having same problem, Medicare denied the Dx codes we have in chart are Z29.9. We called Medicare got a call to change Dx to Z29.8 after 1st denial.
Then Mcare recouped, said those dx codes are unacceptable codes as primary dx. We did have Lung C34.2 as our 2ndry code.
 

trarut

True Blue
Messages
673
Location
Columbus, OH
Best answers
0
I'm thinking back to when I coded & billed Rad Onc services. I don't recall ever listing anything other than the cancer code as the cancer code for prophylactic radiation. Any Z code was listed secondary. My reasoning was the radiation was because the cancer was why the radiation was needed; reporting a prophylaxis code was informational in the bigger scheme.
 

rachaelwilleford

Guru
Local Chapter Officer
Messages
105
Location
Carencro, LA
Best answers
0
I'm thinking back to when I coded & billed Rad Onc services. I don't recall ever listing anything other than the cancer code as the cancer code for prophylactic radiation. Any Z code was listed secondary. My reasoning was the radiation was because the cancer was why the radiation was needed; reporting a prophylaxis code was informational in the bigger scheme.
This for the PCI with lung cancer. I still code the lung cancer as primary as it is the reason why they're undergoing treatment.
 
Top