# Malignant fibrous histiocytoma



## lqueve29@yahoo.com (May 4, 2012)

How should I code a
Malignant fibrous histiocytoma with focal perineural invasion
I would go with: 198.82, but some of my coworkers told me I'm going "overboard" with this code.
Do you have any suggestions???
Thanks!!!


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## dmoellma (May 4, 2012)

Per ICD9 Index to Diseases I would search by:Histiocytoma, fibrous, malignant, which states see Neoplasm connective tissue, malignant. This leads you to the note in the neoplasm table under connective tissue with further instruction to code to the site and if site is not mentioned under connective tissue, then code to neoplasm of that site. Hope this helps


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## lqueve29@yahoo.com (May 4, 2012)

Hi, thank you!!! I did that already, and it took me to the same code of 198.82
But, that is a malignant secondary code in the neoplasm connective tissue table. Since the perineural invasion(PNI) is known as "a pathologic process in which tumor cells will invade into nervous structures and spread along nerve sheaths", then I think this is a methastatic tumor that should be coded as a connective tissue malignant secondary
Thanks again for your help!!!


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