Home Health ICD-9/ICD-10 Alert

Question: Our patient had surgery to remove liver tumors. He will be receiving radiation therapy. I listed V58.42 as primary. Should I list 155.0 for the malignant neoplasm of liver in M0240 or M0246?

-- New York Subscriber

Answer: First confirm that the liver tumors are malignant and, if they are malignant, whether they are primary malignancies. Malignancies of the liver are usually secondary.

If the tumors are primary cancer, then you should list 155.0 (Malignant neoplasm of liver and intraheptic bile ducts; liver, primary). If aftercare is the focus of care, you would report V58.42 (Aftercare following surgery for neoplasm) as primary provided the focus of your care is the aftercare.

The liver cancer is the underlying diagnosis to the V code, but according to Attachment D you don't need to list this diagnosis in M0246 because the code is also reported in M0240. If the liver cancer was resolved, then you would not report this diagnosis in M0240, but instead list it in M0246.