Q: A patient undergoes placement of a MediPort® to receive chemotherapy for lung cancer. What principal diagnosis should we report? Should we report V58.81 (fitting and adjustment of vascular catheter) or 162.9 (malignant neoplasm of bronchus and lung unspecified)?
A: To accurately answer this question, it’s important to determine whether the admission is truly for the administration of chemotherapy. This would mean that the MediPort is simply a conduit for administration. The ICD-9-CM Official Guidelines for Coding and Reporting state the following:
If a patient admission/encounter is solely for the administration of chemotherapy, immunotherapy or radiation therapy, assign code V58.0 (encounter for radiation therapy) or V58.11 (encounter for antineoplastic chemotherapy) or V58.12 (encounter for antineoplastic immunotherapy) as the first-listed or principal diagnosis. If a patient receives more than one of these therapies during the same admission more than one of these codes may be assigned, in any sequence. The malignancy for which the therapy is being administered should be assigned as a secondary diagnosis.
MediPort placement does not typically support an inpatient episode of care, so my assumption is this patient is being admitted for the chemotherapy. Thus, the principal diagnosis is V58.11 (encounter for antineoplastic chemotherapy) followed by 162.9.
Editor’s note: Cheryl Ericson, MS, RN, CCDS, CDIP, CDI education director at HCPro, Inc. in Danvers, MA answered this question.
This answer was provided based on limited information submitted to JustCoding. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
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