# Malignant ascites 789.51



## wblock (Nov 25, 2013)

First of all, thank you for any assistance you can provide.  If possible,  could you also provide a reference when answering?  I am interested in understanding what the rules are when it comes to assigning the ICD-9 codes for malignant ascites.  I am coding for the professional side. What is the correct ICD-9 code(s) assignment to the following hospital based procedure?

Clinical indications:  Colon cancer with symptomatic ascites

Procedure performed:  Ultrasound guided paracentesis (description of the procedure follows).

Impression:  Successful ultrasound guided paracentesis of approximately 6700 cc of clear yellow ascitic fluid.  Fluid was sent to lab and cytology for further analysis.

Note:  This is the only report I have to code.  I do not have access to the rest of the medical record.

Which is the correct ICD-9 code(s)?

1.)First listed:  153.9
    Second listed:  789.51

or

2.) First listed:  789.5

or 

3.)First listed:  789.5
    Second listed:  153.9


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## atipton12 (Nov 25, 2013)

Per the AAPC ICD9CM coding book, under Malignant ascites 789.51 states "code first malignancy such as: malignant neoplasm of ovary (183.0) or secondary malignant neoplasm of retroperitoneum and peritoneum (197.6)"

My interpretation of this note is to code first your malignancy of colon as primary ICD9 
(153.9) then malignant ascites as your secondary ICD9 (789.51) when diagnosing 'malignant ascites.'

If they did not determine malignancy in the ascites fluid, I would then code other ascites 
(789.59) as primary ICD9 then code malignancy of colon as secondary ICD9 (153.9) if the malignancy of the colon is actively being treated.

You can also find more information in the Coding Guidelines in the front of the AAPC ICD9CM coding book.

Hope this helps.


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