# Dx cancer coding help



## Tonyj (Nov 10, 2010)

Cancer codes always give me a hard time. Can anyone assist me with these diagnosis codes? I can use a code given by the path report but what about the mets? Thanks in advance. Please read below.

Physicians Note: 10/1/10
CT- extensive mets. Diagnosed with metastatic carcinoma most consistent with urothelial primary. 
What Dx code should I use???

History: pt had renal cell carcinoma 1996 (removed by nephrectomy); Melanoma L arm - resected in 02/2009 (superficial spreading- 0.75 mm)

As per cytopathology report: ICD9 Codes:  198.5 
CLINICAL INFORMATION: 
  History of melanoma and right nephrectomy for ureteral tumor. 
  Now with apparent metastatic lesions. 
Findings:
Bone, left ilium (CT-guided fine needle aspiration): 
       Metastatic carcinoma, most consistent with urothelial 
  primary (see comment). 

       Cell Block Study:  Metastatic carcinoma, most consistent 
  with urothelial primary.

Tonyj


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## kbazarte@yahoo.com (Nov 10, 2010)

for the renal cell ca the code would be V10.52 from the info given stating history not current malignancy

the melanoma would also be a history code V10.82

the bone mets would be 198.5 as the primary code followed by V10.52 ans V10.82


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## Tonyj (Nov 10, 2010)

Thanks for your response.
Do I also code the urothelial primary?

Tonyj


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## boozaarn (Nov 14, 2010)

*you do not code "consistent with"*

I think that you should code it this way
198.5; V10.52; v10.82;v45.73 and v45.89


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