Neurosurgery Coding Alert

Question: How can we report the proper diagnosis code for hemorrhagic melanoma with intracranial metastases? Is it correct to report 198.3 (Secondary malignant neoplasm of brain and spinal cord) and 431 (Intracerebral hemorrhage)?

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Answer: Since the hemorrhage is a secondary consequence of the metastatic melanoma, the best primary diagnosis code to use is ICD-9 code 198.3. You can also report the hemorrhagic complication of the metastasis with ICD-9 code 431 if the E&M service or procedures performed are to treat the hemorrhagic complication.