# Atypical Ductal Hyperplasia-opinion



## Tonyj (Aug 13, 2013)

Could/should ADH "Atypical Ductal Hyperplasia" be coded as 238.3 or 610.8?


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## ehanna (Aug 13, 2013)

Going by my CPT I would code 610.8


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## BlakeCarswell82 (Aug 13, 2013)

We have always coded it as 610.8


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## Tonyj (Aug 13, 2013)

Could it also be classified as a neoplasm with uncertain behavior? According to all information I'm reading on this it would/could fit. Any definite classification would be appreciated.


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## BEARDOG (Aug 14, 2013)

atypical ductal hyperplasia (ADH) when found on core breast biopsy has to have an open excisional biopsy done to make sure that there is no malignancy as it can be indicative of cancer.  I usually use 239.3 as the ICD9 code for the subsequent office visit, etc.  However, my surgeon states ADH is uncertain behavior and that  would fit  238.3.

Hope that helps  
Debbie, CPC, CGSC


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## BlakeCarswell82 (Aug 14, 2013)

Look it up under Hyperplasia
                                Breast
                                      Ductal
                                            Atypical - 610.8
Unless your doctor specifically says that it is a neoplasm of uncertain behavior, the 610.8 is the most specific code.


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## BEARDOG (Aug 15, 2013)

I guess we will agree to disagree.  If ADH is the pathological diagnosis on the final excisional biopsy then 610.8 would be fine, however, if ADH is on an FNA or core biopsy I do not feel 610.8 would be as accurate as 239.3.  ADH that is found on this type of biopsy is an indicator for more evaluation (excisional biopsy-where the entire lesion is removed) as cancer is often found upon further evaluation of ADH.


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## Tonyj (Aug 15, 2013)

BEARDOG said:


> I guess we will agree to disagree.  If ADH is the pathological diagnosis on the final excisional biopsy then 610.8 would be fine, however, if ADH is on an FNA or core biopsy I do not feel 610.8 would be as accurate as 239.3.  ADH that is found on this type of biopsy is an indicator for more evaluation (excisional biopsy-where the entire lesion is removed) as cancer is often found upon further evaluation of ADH.



Path report states:
1. LEFT BREAST, SUPERIOR, STEREOTACTIC VACUUM ASSISTED CORE BIOPSY:
- CORES OF BREAST TISSUE WITH A SMALL FOCUS OF ATYPICAL DUCTAL HYPERPLASIA WITH
ASSOCIATED CALCIFICATIONS.
- CALCIFICATIONS ARE ALSO PRESENT WITHIN ATROPHIC LOBULES.

ICD9 takes me to 610.8. I hate giving a neoplasm code unless it's specified but I needed other opinions.


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