2022 ICD-10-CM Diagnosis Code Z51. 11: Encounter for antineoplastic chemotherapy.
1 for Encounter for antineoplastic chemotherapy and immunotherapy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
2022 ICD-10-PCS Procedure Code 3E03305: Introduction of Other Antineoplastic into Peripheral Vein, Percutaneous Approach.
ICD-10-CM Code for Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter T45. 1X5A.
Chemotherapy administration codes, 96400 through 96450, 96542, 96545, and 96549, are only to be used when reporting chemotherapy administration when the drug being used is an anti-neoplastic and the diagnosis is cancer.
ICD-10 Classifications The ICD-10 section that covers long-term drug therapy is Z79, with many subsections and specific diagnosis codes. Because Plaquenil does not have its own specific category, clinicians should use Z79. 899—Other Long Term (Current) Drug Therapy.
ICD-10-PCS will be the official system of assigning codes to procedures associated with hospital utilization in the United States. ICD-10-PCS codes will support data collection, payment and electronic health records. ICD-10-PCS is a medical classification coding system for procedural codes.
Extirpation is defined as taking or cutting out solid matter or material from a body part. This root operation represents a range of procedures where the body part itself is not the focus of the procedure.
In ICD-10-PCS the seventh character defines the qualifier – i.e., an additional attribute of the procedure, if applicable.
Breast Cancer ICD-10 Code Reference SheetFEMALERightC50.811Malignant neoplasm of overlapping sites, right female breastC50.911Malignant neoplasm of unspecified site, right female breastD05.01Lobular carcinoma in situ, right breast9 more rows
ICD-10 Code ICD-10 Description Assign when immunodeficiency is due to: D84. 821 Immunodeficiency due to drugs Medications that interfere with the immune system. These medications include immunosuppressants, corticosteroids, and chemotherapy.
Antineoplastic drugs are medications used to treat cancer. Other names for antineoplastic drugs are anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs.
Z51. 11 is attached to the billing for the administration of chemotherapy so would not be used by the provider when the patient is going to a hospital-owned infusion center.
Intravenous (IV) infusions are billed based upon the CPT®/HCPCS description of the service rendered. A provider may bill for the total time of the infusion using the appropriate add-on codes (i.e. the CPT®/HCPCS for each additional unit of time) if the times are documented.
Antineoplastic drugs are medications used to treat cancer. Other names for antineoplastic drugs are anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs.
Antineoplastic chemotherapy drugs are a type of medication that doctors use to treat cancer. They contain chemicals that kill cells that rapidly divide, including cancer cells.
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere.
Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells). The ovaries are part of the female reproductive system. They produce a woman's eggs and female hormones.
Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified ( C25.9 ). A primary or metastatic malignant neoplasm involving the ovary.
Metastatic malignant neoplasms to the ovary include carcinomas, lymphomas, and melanomas. Cancer that forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed).
They produce a woman's eggs and female hormones. Each ovary is about the size and shape of an almond.cancer of the ova ry is not common, but it causes more deaths than other female reproductive cancers. The sooner ovarian cancer is found and treated, the better your chance for recovery.
C56 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
Carcinoma of right lower lobe of lung with metastatic carcinoma of intrathoracic lymph nodes.
Metastatic odontogenic fibrosarcoma. (note the unknown metastatic site code C79.9 is added as a secondary code and is presumed in this example. Assign the principal or first-listed code only).
When a primary malignancy has been previously excised or eradicated from its site and there is no further treatment directed to that site and there is no evidence of any existing primary malignancy at that site, a code from category Z85, Personal history of malignant neoplasm, should be used to indicate the former site of the malignancy. Any mention of extension, invasion, or metastasis to another site is coded as a secondary malignant neoplasm to that site. The secondary site may be the principal or first-listed with the Z85 code used as a secondary code.
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion '), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous such as tumors in different quadrants of the same breast, codes for each site should be assigned.
The neoplasm table in the Alphabetic Index should be referenced first. However, if the histological term is documented, that term should be referenced first, rather than going immediately to the Neoplasm Table, in order to determine which column in the Neoplasm Table is appropriate. Alphabetic Index to review the entries under this term and the instructional note to “see also neoplasm, by site, benign.” The table provides the proper code based on the type of neoplasm and the site. It is important to select the proper column in the table that corresponds to the type of neoplasm. The Tabular List should then be referenced to verify that the correct code has been selected from the table and that a more specific site code does not exist.
Chapter 2 of the ICD-10-CM contains the codes for most benign and all malignant neoplasms. Certain benign neoplasms , such as prostatic adenomas, may be found in the specific body system chapters. To properly code a neoplasm, it is necessary to determine from the record if the neoplasm is benign, in-situ, malignant, or of uncertain histologic behavior. If malignant, any secondary ( metastatic) sites should also be determined.
When a pregnant woman has a malignant neoplasm, a code from subcategory O9A.1 -, malignant neoplasm complicating pregnancy, childbirth, and the puerperium, should be sequenced first, followed by the appropriate code from Chapter 2 to indicate the type of neoplasm. Encounter for complication associated with a neoplasm.
When the reason for admission/encounter is to determine the extent of the malignancy, or for a procedure such as paracentesis or thoracentesis, the primary malignancy or appropriate metastatic site is designated as the principal or first-listed diagnosis, even though chemotherapy or radiotherapy is administered.
When a patient is admitted because of a primary neoplasm with metastasis and treatment is directed toward the secondary site only , the secondary neoplasm is designated as the principal diagnosis even though the primary malignancy is still present .
In 2018, the CPT code 38573 (Laparoscopy, surgical ; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy (ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy (ies), when performed.) was created to address situation where a Gyn Onc is asked to perform staging where another surgeon has performed the laparoscopic BSO ± hysterectomy.
For a laparoscopic BSO with staging (for a patient with prior hysterectomy, for instance), you can use the CPT code 38573 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy (ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy (ies), when performed) with a -22 modifier. That would be billed with the laparoscopic BSO CPT code 58661 with the -59 modifier for a second surgery. With any -22 modifier, you would need to have an operative note and letter requesting increased reimbursement with the rationale, in this case the extra time and effort for “debulking”.
This code specifically excludes hysterectomy codes. If you perform a laparoscopic hysterectomy, BSO, debulking, the proper CPT code would be 58575 (Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed).
The operative report documentation should clearly describe the procedure and the reason for performing it. You should also append a distinct ICD code, such as C78.5, secondary malignant neoplasm of the large bowel.
The series 58950-58952 can only be used with ICD10 codes for ovarian, tubal or primary peritoneal malignancy. 58953-58954 may be used with any diagnosis. All describe various combinations of procedures commonly performed for advanced gynecologic cancers.
49205 is not to be used in this circumstance. The procedure described is an oophorectomy and the code 58720 is the same regardless of the size of the ovary. If there is excessive work required it should be documented in the operative report and a modifier 22 may be added. The 4920X codes are used when managing masses not involving the uterus, cervix, fallopian tube or ovary.
Those procedures are included as “debulking”. 58957 is a code that is used for resection of recurrent gynecologic cancer. If you are doing a primary debulking then you should use 58952-58954 depending on what else is done.