Hello,
I could use some help with an audit/education dispute.
When inserting a port-a-cath (cpt 36561) for chemo, what is the 1st listed dx? Z45.2 (2ndary code cancer) -or- cancer code (ex. C56.–, no Z code).

Education: Z45.1- Rationale: see index logic …Admission for…Fitting (of)…Port-a-cath = Z45.2. Fitting means installing, putting in, placing.
Auditing: Cancer code. Rationale: ICD guideline- Section I.C.21.c.7. "The aftercare Z code should not be used if treatment is directed at a current, acute disease. The diagnosis code is to be used in these cases.". the catheter is initially being inserted for treatment of the cancer if the patient had a problem later on with the catheter and it needed to be replaced or when chemo is done and the catheter needs to be removed you would use the Z code because at time the treatment is being directed at the catheter not the cancer.

Thanks for any advice.
Kim