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V58.0 Encounter/Admission for radiation therapy

  1. Default V58.0 Encounter/Admission for radiation therapy
    Medical Coding Books
    ICD9 guidelines state this diagnosis code should always be primary. Should this code only be attached to the actual treatment codes (tech) or to all codes related to the patients care including pro charges?

  2. #2
    Location
    Louisville, KY
    Posts
    1,101
    Default
    It is also acceptable as a Primary for professional fee services. The caveat here would be that as long as the services relate to radiation therapy of some sort, V58.0 is appropriate.

    Good luck and hope this helps. You can see your ICD manual for further details.

  3. Default V58
    Can it be an outpatient visit or does it have to be inpatient?

  4. #4
    Location
    Charleston, WV
    Posts
    245
    Default
    Yes, it can be outpatient.

  5. Default
    The ICD-9 guidelines does state to use primary, but there is an exception of when there are multiple encounters on the same day and the medical records for the encounters are combined or when there is more than one V code that meets the definition of principle dx.

    SO...at my clinic we bill chemo drugs out with the cancer code, then put the ca code and
    V58.11 or V58.12 secondary when doing the administration codes for the chemo. They usually have an office visit on the same day too which we would put a modifier 25 on. But even if they don't have an office visit or anything, the payors have told us they absolutely do not want to see the V58.xx codes first. Payor vs. ICD-9 guidelines. Payor trumps, right?

    Amanda, CPC
    Urology coder

  6. #6
    Location
    Columbia, MO
    Posts
    12,531
    Default
    No the coding guidelines trump.
    These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-9-CM itself.
    Adherence to these guidelines when assigning ICD-9-CM diagnosis and procedure codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Volumes 1-2) have been adopted under HIPAA for all healthcare settings.

    V58.11, and V58.12 are first listed only and it is non compliant to list these codes secondary. If the office visit vist is for a planned chemo encounter then you cannot charge the ov code with the 25 modifier.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
    Location
    Columbia, MO
    Posts
    12,531
    Default
    No the coding guidelines trump.
    These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-9-CM itself.
    Adherence to these guidelines when assigning ICD-9-CM diagnosis and procedure codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Volumes 1-2) have been adopted under HIPAA for all healthcare settings.

    V58.11, and V58.12 are first listed only and it is non compliant to list these codes secondary. If the office visit vist is for a planned chemo encounter then you cannot charge the ov code with the 25 modifier.

    Debra A. Mitchell, MSPH, CPC-H

  8. Default Radiation tx
    Hi ,when a pte visit a clinic and pcp document that is in radiation tx , which code i can use?
    Thanks

  9. #9
    Location
    Columbia, MO
    Posts
    12,531
    Default
    Your post is not really clear. If the patient presents for radiation therapy the the V 58.0 code for encounter for radiation therapy is first listed followed by the neoplasm code. If the encounter is for other reasons then you code whatever the reason for the encounter is, the fact that the patient is currently undergoing radiation is not coded.

    Debra A. Mitchell, MSPH, CPC-H

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