# Cancer coding



## daniel (Apr 15, 2010)

I cut and pasted this portion of the note.



Studies:
Path: Brain biopsy now showed metastatic adenoCA from lung.

CT guided lung biopsy showed necrotic materials



Impressions/plan:

#  Newly dx metastatic adenoCA with brian metastasis. the patient brian biopsy initially showed Glioblastoma multiforme but additional staining showed metastatic ADENOCA from lung. Lung CT guided biopsy showed necrotic material only.


 My question;



How do you code for brain metatstatic adeno Ca from the lung.

Do I code it as secondary or primary 



The confusion comes because the lung is not cancerous. 



So is the Brain coded as secondary and then just code the lung with 513.0 for the necrotic material shown on the biopsy.



Thank You
Daniel


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## mitchellde (Apr 15, 2010)

If he states adenocarcinoma from the Lung and there is no current evidence of lung CA then I would assume that it is hx of so code the brain mets as your primary dx code and use a v10.x for hx of lung CA.


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## daniel (Apr 15, 2010)

Thank You.


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## gaponte (Apr 16, 2010)

I will use code 198.3 for the metastasis. According to ICD-9-CM coding guidelines chapter 2 section: “any mention of extension, invasion, or metastasis to another site is coded as a secondary malignant neoplasm”. Therefore, the correct coding would be 198.3, 513.0, V10.11


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## ram (Dec 12, 2010)

*adenocarcinoma*

It appears that the scenario to be more simple. As they have confirmed the existence of adenocarcinoma of lung, we should opt for 162.9 and 198.3. Because, adenocarcinoma always lead to malignant condition always. Is it not?


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