ICD-10-CM Diagnosis Code T45.1. Poisoning by, adverse effect of and underdosing of antineoplastic and immunosuppressive drugs. Antineoplastic and immunosuppressive drugs; …
Oct 01, 2021 · Z79.810 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Lng trm (crnt) use of slctv estrog …
May 02, 2022 · ICD-10-CM coding for tamoxifen depends on intent of the therapy. Question: The patient was diagnosed with breast cancer and is status post mastectomy. There is no active …
Oct 01, 2021 · Z92.23 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z92.23 became …
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)
Z79.810 is a billable diagnosis code used to specify a medical diagnosis of long term (current) use of selective estrogen receptor modulators (serms). The code Z79.810 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals. The code Z79.810 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
Z79.810 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
The 2022 edition of ICD-10-CM T38.6X5A became effective on October 1, 2021.
T38- Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified
mineralocorticoids and their antagonists ( T50.0-) oxytocic hormones ( T48.0-) parathyroid hormones and derivatives ( T50.9-) Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code. Type 1 Excludes.
Answer: Assign code 174.9 Malignant neoplasm of female breast, unspecified as the first-listed diagnosis, since Herceptin is considered cancer treatment. Assign code V58.69, Long-term (current) use of other medications, for the Herceptin maintenance. Herceptin therapy is not antineoplastic chemotherapy, but is a biological adjuvant treatment for women with breast cancers that are HER2 positive (with cancer cells overexpressing Human Epidermal Growth Factor Receptor 2).
The ICD-9-CM distinguishes between current cases of cancer and personal history of cancer. The use of long term prophylactic agents to prevent recurrence of disease raises questions as to when treatment is actually complete (credit clay ). This issue was raised with gynecologists at ACOG. These agents are used to prevent recurrence and metastasis, so classifying their use as prophylactic is valid, regardless of whether a cancer code or a V code for history of cancer is used. (emphasis mine)
My issue is that Herceptin and tamoxifen are very different in their action and purpose. Herceptin is an adjuvant therapy, while tamoxifen is a hormonal therapy. Go go to the federal National Institute of Cancer website, http://www.cancer.gov/cancertopics/types/breast/adjuvant-fact-sheet, to read that there is a difference between the two therapies, described as follows:
In other words, agents including tamoxifen may be used for active cancer treatment OR as pro phylaxis in history of cancer, based on the rest of the patient’s treatment “history.” Rejecting active cancer as a code leaves a big HCC behind in risk adjustment, but it represents money that may be wrongly acquired, if the only current “treatment” is tamoxifen.
Studies have shown that tamoxifen helps prevent the original cancer from returning and also helps to prevent the development of new cancers in the other breast. Herceptin is adjuvant therapy, tamoxifen is hormonal therapy.