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Question: What is the correct primary diagnosis code for Keytruda? Should I use Z51.11 or Z51.12? Also, does the diagnosis coding change if a patient receives only Keytruda, or if the patient receives a pre-medication and then the Keytruda?

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Answer: According to the , the drug, coded to J9271 (Injection, pembrolizumab, 1 mg) is immunotherapy and should be classified as such in your diagnostic coding for the encounter. This means you should use Z51.12 (Encounter for antineoplastic immunotherapy) rather than Z51.11 (Encounter for antineoplastic chemotherapy) if a Keytruda infusion is the primary reason for the patient visit.

This coding would not change for the two scenarios you provide, as the Keytruda infusion is the primary reason for both encounters as you describe them.

Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC