| Specialty
Groups — Oncology
Medical Oncology Code Changes ACOA’s Coding Corner – November 2005 New Diagnosis Codes Explained Effective October 1, 2005 diagnosis code V58.1 requires a 5th digit to be considered complete: V58.11 – Encounter for antineoplastic chemotherapy V58.12 – Encounter for antineoplastic immunotherapy According to the Official ICD-9-CM Diagnosis Coding Guidelines, a patient admitted for radiotherapy, chemotherapy, or immunotherapy is assigned a V code (V58.0, V58.11 or V58.12) as the primary diagnosis. The cancer, disease, or condition is reported as a secondary diagnosis. When procedures V58.0 (encounter for radiotherapy) and V58.11 or V58.12 are performed simultaneously, both may be reported on the same record, with either one sequenced first. The difference: Immunotherapy stimulates the body’s own immune defense system to fight infection and disease, and chemotherapy attacks cancer cells themselves. What is essential to understand is that these V codes are primarily used for tracking purposes, and do not affect reimbursement. Examples of immunotherapy include Bacille Calmette-Guerin (BCG), interferon-alfa (IFN-alfa), interleukin-2 (IL-2), and other monoclonal antibodies.” While these codes are defined as ‘primary’ codes by the ICD-9-CM Manual, additional diagnosis codes are reported to define the location of the malignancy or other condition under treatment, as well as diagnosis codes for signs and symptoms (i.e., nausea, fatigue, pain, etc.). This combination of diagnosis codes provides a complete picture of the individual patient treatment provided. Watch for more 2005 coding changes in the upcoming months. Review previous Coding and Reimbursement Updates. This Coding and
Reimbursement Update was prepared by:
Cindy
C. Parman, CPC, CPC-H
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