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ICD-10-CM Diagnosis Code T45.1 Poisoning by, adverse effect of and underdosing of antineoplastic and immunosuppressive drugs Antineoplastic and immunosuppressive drugs; poisoning by, adverse effect of and underdosing of tamoxifen (T38.6) ICD-10-CM Diagnosis Code Z79.810 [convert to ICD-9-CM]
Long-term (current) use of other medications. ICD-9 V58.69 is a legacy non-billable code used to specify a medical diagnosis of long-term (current) use of other medications.
ICD-9 Code V58.69. The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
Not Valid for Submission. ICD-9 V58.69 is a legacy non-billable code used to specify a medical diagnosis of long-term (current) use of other medications. This code was replaced on September 30, 2015 by its ICD-10 equivalent.
ICD-10-CM Code for Long term (current) use of selective estrogen receptor modulators (SERMs) Z79. 810.
V58. 69 - Long-term (current) Use of Other Medications [Internet]. In: ICD-10-CM.
Associated ICD-10-CM Codesaldesleukin (Proleukin)J9015 - Injection, aldesleukin, per single-use vial✔hydroxyurea (Hydrea)S0176 - Hydroxyurea, oral, 500 mg✔hydroxyurea (Hydrea)J8999* - Prescription drug, oral, chemotherapeutic, not otherwise specified✔ifosfamide (Ifex)J9208 - Injection, ifosfamide, 1 g✔42 more rows
The 2022 edition of ICD-10-CM Z79. 810 became effective on October 1, 2021. This is the American ICD-10-CM version of Z79.
ICD-10 code Z79. 899 for Other long term (current) drug therapy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
ICD-10-CM Diagnosis Code Z79 Z79.
Tamoxifen is in a class of medications known as antiestrogens. It blocks the activity of estrogen (a female hormone) in the breast.
ICD-10-PCS GZ3ZZZZ is a specific/billable code that can be used to indicate a procedure.
ICD-10 Codes for Long-term TherapiesCodeLong-term (current) use ofZ79.899other drug therapyH – Not Valid for Claim SubmissionZ79drug therapy21 more rows•Aug 15, 2017
A: Assign a code from Z79 if the patient is receiving a medication for an extended period as a prophylactic measure (such as for the prevention of deep vein thrombosis) or as treatment of a chronic condition (such as arthritis) or a disease requiring a lengthy course of treatment (such as cancer).
Encounter for therapeutic drug level monitoring. Z51. 81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Long-term medicine Any medicine you have to take for three or more months to control symptoms or to prevent complications from a condition. Examples of conditions that might require long-term medicine include: high blood pressure, high cholesterol, diabetes, arthritis, heart conditions, and long-term pain.
V58.69 is a legacy non-billable code used to specify a medical diagnosis of long-term (current) use of other medications. This code was replaced on September 30, 2015 by its ICD-10 equivalent.
Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
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)
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).
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.
The 2022 edition of ICD-10-CM Z79.810 became effective on October 1, 2021.
Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status
Tamoxifen can be prescribed for 5-10 years depending on the risk of cancer recurrence. A patient on Tamoxifen alone does not meet the criteria for coding as an additional diagnosis.
Research indicates that tamoxifen is a hormone treatment for breast cancer. Tamoxifen is used to treat breast cancer when surgery is not appropriate, and as adjuvant treatment of oestrogen-receptor positive early breast cancer, as it reduces the risk of breast cancer recurrence, and the risk of developing a second breast cancer.