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Post chemo monitoring

  1. #1
    Question Post chemo monitoring
    Medical Coding Books
    Would V58.69 be an appropriate code for a home health agency to use as primary dx for monitoring a patient currently on chemotherapy, but not administering it? Is there another code that would be better?

  2. #2
    Columbia, MO
    V58.6x codes are all secondary only allowed dx codes. V58.83 encounter for therapeutic drug monitoring is allowed first and requires a V58.6x code as a secondary code. This may fit your scenario, but I would need to know more to make a full determination.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Goodness, you are right, it can only be used as secondary code. Our home health nurse wanted to use V67.2, but we saw that was only for use if treatment was completed, which it is not (it also looks like a code for treating physician only as well?). She is basically assessing the effects of chemotherapy as part of her nursing assignment, but not, as V58.83 says, measuring drug levels in the body. I am new at this, and we have a very small home health side, really for pre-hospice pts. We were advised by another home health agency to use V58.11, but we are not providing the chemotherapy either, so that can't be right.

  4. #4
    Columbia, MO
    Perhaps using the cancer code then is what you need to do since that is the patient's main issue and why the nurse is there and monitoring for side effects is just part of the disease process then you can use the V58.69 second.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Thanks for the input! I'll go over it w/the clinical director.

  6. #6
    BTW, one more question, about V66.2........can't find much description or any examples of using this code; would this apply in any way to our situation?

  7. #7
    Columbia, MO
    That is a code for convalesence following chemo. It is first listed only and for when the purpose is convalesent care only. Usually this is used after all chemo tx and the patient just needs some care to bring them back up to speed. Not generally used while chemo is still ongoing.

    Debra A. Mitchell, MSPH, CPC-H

  8. #8
    thanks again.........................

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