Wiki Request for Confirmation: ICD-10-CM Diagnosis for Billing Keytruda (J9271)

[vpriya@scioms.com]

Hello Everyone, I’m looking for clarification on the appropriate ICD-10-CM diagnosis codes for billing when administering the drug Keytruda (J9271) under different scenarios.

Scenario 1:
When a patient receives only Keytruda for a 30-minute infusion, what would be the correct primary diagnosis code for this encounter? Specifically, should we be coding Z51.11 (Encounter for antineoplastic chemotherapy) or Z51.12 (Encounter for antineoplastic immunotherapy)?

Scenario 2:
If a patient receives both pre-medications and Keytruda as part of their treatment plan, what would the primary diagnosis code be for this encounter? Again, should we use Z51.11 or Z51.12 for this situation?

I would greatly appreciate confirmation or any additional insights regarding the proper diagnosis coding to ensure accurate billing.

Thank you,
Vishnupriya

diagnosis codes, diagnosis coding

 

[LKaf7]

I would use Z51.12 in both cases as Keytruda is an immunotherapy

diagnosis codes, diagnosis coding