The new codes are for describing the infusion of tixagevimab and cilgavimab monoclonal antibody (code XW023X7), and the infusion of other new technology monoclonal antibody (code XW023Y7).
Search the full ICD-10 catalog by:
The ICD-10-CM is a catalog of diagnosis codes used by medical professionals for medical coding and reporting in health care settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates.
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 .
Report ICD-10 code Z01. 818, Encounter for other preprocedural examination (is defined as Encounter for preprocedural examination NOS and Encounter for examinations prior to antineoplastic chemotherapy), when the test is performed as a baseline study before chemotherapy. List Z01. 818 as your primary diagnosis code.
2022 ICD-10-PCS Codes 3E04*: Central Vein.
Encounter for antineoplastic chemotherapy Z51. 11 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 Z51. 11 became effective on October 1, 2021.
Code 96413 (chemotherapy administration, intravenous infusion technique; up to one hour, single or initial substance/drug) would be used to report the first 90 minutes of the infusion.
ICD-10 Code for Other long term (current) drug therapy- Z79. 899- Codify by AAPC.
Z45. 2 - Encounter for adjustment and management of vascular access device. ICD-10-CM.
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.
ICD-10-CM Diagnosis Code Z97 Z97.
ICD-10-CM Code for Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter T45. 1X5A.
Report CPT s 96366, 96367, 96375 to identify a therapeutic, prophylactic, or diagnostic drug infusion or injection, if administered as secondary, or a subsequent service, in association with 96413 when through the same access.
If a patient admission/encounter is solely for the administration of chemotherapy, immunotherapy or external beam radiation therapy assign code Z51. 0, Encounter for antineoplastic radiation therapy, or Z51.
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.
There are also codes Z85.6, Personal history of leukemia, and Z85.79, Personal history of other malignant neoplasms of lymphoid, hematopoietic and related tissues. If the documentation is unclear as to whether the leukemia has achieved remission, the provider should be queried.
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.
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.
Code C80.0, Disseminated malignant neoplasm, unspecified, is for use only in those cases where the patient has advanced metastatic disease and no known primary or secondary sites are specified. It should not be used in place of assigning codes for the primary site and all known secondary sites.
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.
Code C80.1, Malignant ( primary) neoplasm, unspecified, equates to Cancer, unspecified. This code should only be used when no determination can be made as to the primary site of a malignancy. This code should rarely be used in the inpatient setting.
CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS Internet-Only Manual, Pub 100-02, Chapter 15, §50.4.1 Approved Use of Drug and §50.4.5 Off Label Use of Anti-Cancer Drugs and Biologicals
The purpose of this article is to provide billing guidance for chemotherapeutic agents, that are usually billed as “incident to” medications under Part B.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.