Inpatient Facility Coding & Compliance Alert
Reader Question:
List Treated Neoplasm as Principal Diagnosis
Published on Thu Apr 11, 2013
Question: Is there ever a time when a secondary malignancy can be the first listed code on a claim?
Answer: Yes, a secondary malignancy can sometimes be the first diagnosis listed on a claim.
Proof: The 2013 ICD-10-CM Official Guidelines for Coding and Reporting – 1.C.2.b state, "When a patient is admitted because of a primary neoplasm with metastasis and treatment is directed toward the secondary site only, the secondary neoplasm is designated as the principal diagnosis even though the primary malignancy is still present." For instance, a neoplasm of the lung may metastasize to the liver which may then be the subject for treatment.
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