Gastroenterology Coding Alert

Question: Our office began seeing a new patient with MALT lymphoma last month, but I've never heard of the condition. The physician performed a level 4 E/M service on the patient, but I haven't sent the claim out yet because I'm unclear on the proper diagnosis codes. What does the 'MALT' in MALT lymphoma stand for, and what are some possible diagnosis codes for the condition?

Alabama Subscriber.

Answer: MALT lymphoma stands for Mucosa Associated Lymphoid Tissue tumor, and there is currently no ICD-9 code that exactly matches the condition. There are a couple of options when choosing a diagnosis code for MALT lymphoma; the one you settle on will probably depend on the insurance carrier.

On the claim, you could:
   report 99204 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity) for the office visit.
   attach ICD-9 code 202.8x (Other lymphomas) to 99204. You might also represent MALT lymphoma with 238.9 (Other lymphatic and hematopoietic tissues; site unspecified). If you choose this diagnosis code, you should:
   report 99204 for the office visit.
   attach 238.9 to 99204. Best bet: Contact your carrier, talk to a representative and ask her what diagnosis code the carrier desires for MALT lymphoma claims.