Results 1 to 10 of 10

Dose of B-12 for preventative use

  1. #1
    Location
    Spokane WA
    Posts
    11
    Default Dose of B-12 for preventative use
    Exam Training Packages
    We are having a patient start Alimta (Pemetrexed) next week and will be giving a B-12 shot in the day(s) prior as a preventative measure from the complications of Alimta. What ICD-9 is appropriate to use for this?

  2. #2
    Red face B-12
    I would most likely use V67.51

  3. #3
    Location
    Spokane WA
    Posts
    11
    Default
    The problem with that code is the B-12 we are giving is not "following completed treatment", but rather "prior to" treatment.

  4. Default B-12
    possibility, can we use V07.39 ?

    check out the link :

    http://docs.google.com/viewer?a=v&q=...wBYB1_8gFqG6eA

  5. #5
    Default B-12 w/ Alimta
    Th purpose of B-12 shot (w/ Alimta as a prophylaxis) is to prevent or reduced treatment-related hematologic and GI toxicities. My take on this is V07.2 Prophylactic Immunotheraphy. ICD-9 Index, main term: Prophylactic, under subterm: antitoxin.
    Last edited by margsablan; 05-29-2010 at 02:20 AM.

  6. #6
    Default
    Since B12 is a part of Alimta protocol, we have been reporting it with one of 162.x series codes and "per Alimta protocol" under Additional info on CMS-1500.

  7. #7
    Location
    Columbia, MO
    Posts
    12,572
    Default
    Quote Originally Posted by lpetrova View Post
    Since B12 is a part of Alimta protocol, we have been reporting it with one of 162.x series codes and "per Alimta protocol" under Additional info on CMS-1500.
    ?? If you assign a code from 162.x and the patient is not documented as having a malignant neoplasm of the lung, bronchus or trachea, then you are submitting a fraudulent claim. The coder may never determin the patient's dx. The drug is being given prophylactically so I agree with the V07.x.

    Debra A. Mitchell, MSPH, CPC-H

  8. #8
    Default
    From reading the original question I presumed that the patient had already been diagnosed with a lung ca (otherwise, I don't see how Alimta regimen can be justified – one doesn't precert a chemo regimen without dx, documentation, MD's orders in place or at least, one shouldn't).

    Patients undergoing treatment with Alimta are advised to take folic acid daily and B12 supplements for the duration of treatment. IV injection of B12 is recommended preceding the first dose and every three cycles after that. Payers do consider (at least those I've worked with so far) IV B12 injection a “part of Alimta protocol”.

    With the diagnosis documented, and chemo tx plan targeting the dx in place, fraud is non-issue.

    That is not to say, that V70.8 cannot be reported or that reporting 162.9 with “per Alimta protocol” is more correct.

    Best regards!

  9. #9
    Default
    I researched this some time ago and found it appropriate to use 162.X and payers have not questioned this...yet.

  10. #10
    Location
    Columbia, MO
    Posts
    12,572
    Default
    Quote Originally Posted by lpetrova View Post
    From reading the original question I presumed that the patient had already been diagnosed with a lung ca (otherwise, I don’t see how Alimta regimen can be justified – one doesn’t precert a chemo regimen without dx, documentation, MD’s orders in place or at least, one shouldn’t).

    Patients undergoing treatment with Alimta are advised to take folic acid daily and B12 supplements for the duration of treatment. IV injection of B12 is recommended preceding the first dose and every three cycles after that. Payers do consider (at least those I’ve worked with so far) IV B12 injection a “part of Alimta protocol”.

    With the diagnosis documented, and chemo tx plan targeting the dx in place, fraud is non-issue.

    That is not to say, that V70.8 cannot be reported or that reporting 162.9 with “per Alimta protocol” is more correct.

    Best regards!
    Alimta is also give for lung mets which is a different code. I am just cautioning the use of code per protocol and not per the patient's documented dx. I think use the V code for prophylactic admin with the appropriate cancer code secondary should work fine.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Epidural Re-Dose
    By giardina44 in forum Anesthesia
    Replies: 2
    Last Post: 01-23-2015, 12:39 PM
  2. Test Dose
    By Maryst in forum Hematology/Oncology
    Replies: 4
    Last Post: 02-21-2013, 07:04 AM
  3. Low Dose CT
    By stacie68 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-22-2011, 01:54 PM
  4. Help with a dose amount
    By Andra Striebeck in forum Anesthesia
    Replies: 2
    Last Post: 05-05-2010, 12:26 PM
  5. New Pt Preventative vs. Established Pt Preventative
    By heatherwinters in forum Family Practice
    Replies: 2
    Last Post: 02-21-2008, 08:23 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.