# Neoplasm of uncertain behavior



## kbartrom

I understand that ICD-9 238.2 (Neoplasm of uncertain behavior of skin) should not be used unless the specimen has been sent to path and a firm distinction between malignant and benign can't be made.

What code does a provider use if she/he is not removing the lesion but referring the patient to a dermatologist?


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## nsteinhauser

Have you looked at 239.2?


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## kbartrom

I wondered about 239.2.  I read that it should seldom be used but perhaps the scenario I described is one of those "seldom" times?


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## dmaguire

I would use tabular list Neoplasm, the specific area in question and uncertin behavior if you know it is a neoplasm.  If it comes back benign they will use the begnin code.  That is what I would do.

DLM


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## nsteinhauser

I was taught  - a long time ago - that the only time you can use the 'uncertain behavior' diagnosis codes is when the pathology comes back stating exactly that - something with 'uncertain behavior' - you can't use it for a growth that you don't know if it's benign or malignant.  This is a good question for CPT Assistant.


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## mitchellde

You use the 709.0 or 709.9 when sending the patient to a specialist.  239 code for unspecified according to the AHA is to be used after a preliminary diagnostic study reveals a diagnosis of a tumor of some sort, it is considered a "working diagnosis"  it implies that a preliminary study has shown this to be neither cystic nor an abscess but a tumor which is a neoplastic process that has yet to be determined as to its morphology.


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## DeeCPC

dmaguire said:


> I would use tabular list Neoplasm, the specific area in question and uncertin behavior if you know it is a neoplasm.  If it comes back benign they will use the begnin code.  That is what I would do.
> 
> DLM




I'm sorry, but this is incorrect.  Only use 'uncertain behavior' if pathology returns with uncertain morphology.  I believe this is explained in the front of the ICD-9.

Dee
CPC, CPMA, CPCD


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