Oncology & Hematology Coding Alert

1. 172.3 (Malignant melanoma of skin; other and unspecified parts of face).

The ICD-9 manual contains a note for this code indicating that it covers the skin of the forehead.

Remember: If the physician documents the carcinoma as in situ, you should instead report carcinoma in situ code 232.3 (Carcinoma in situ of skin; skin of other and unspecified parts of face).

2. 217 (Benign neoplasm of breast).

3. 233.9 (Carcinoma in situ of breast and genito-urinary system; other and unspecified urinary organs).

Why unspecified: There isn't a specific diagnosis code for carcinoma in situ for the kidney. You should follow the ICD-9 index neoplasm table entry for renal cancer in situ, which directs you to 233.9.

4. V58.11 (Encounter for antineoplastic chemotherapy) ICD-9 guidelines indicate that you should use this V code as the primary diagnosis code when the patient presents only for chemotherapy.

5. 180.0 (Malignant neoplasm of cervix uteri; endocervix)

6. 155.2 (Malignant neoplasm of liver and intrahepatic bile ducts; liver, not specified as primary or secondary)

7. 141.1 (Malignant neoplasm of tongue; dorsal surface of tongue).

8. 162.4 (Malignant neoplasm of trachea, bronchus and lung; middle lobe, bronchus or lung).

9. 153.9 (Malignant neoplasm of colon, unspecified) along with 197.0 (Secondary malignant neoplasm of respiratory and digestive systems; lung).

Coding conventions call for colon as the primary and lungs as the secondary diagnosis, depending on the specificity of the documentation in the record, says Sandy Giangreco, CPC-OBGYN, CPC-H, CPC-I, corporate revenue integrity specialist with Centura Health Systems, in her recent presentation, "Navigating the Neoplasm Table," for The Coding Institute (http://www.codingconferences.com/oncology08cds_doc_books.htm).

10. 96416 (Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion [more than 8 hours], requiring use of a portable or implantable pump).

11. 154.0 (Malignant neoplasm of rectum, rectosigmoid junction, and anus; rectosigmoid junction).

12. 197.7 (Secondary malignant neoplasm of respir-atory and digestive systems; liver, specified as secondary).

13. V66.7 (Encounter for palliative care).

14. 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug [irinotecan]).

-- The responses to questions 10-14 were provided by Vicky Varley O-Neil, CPC, CCS-P, owner of The Hazlett Group in St. Louis, Mo., and were given during her recent TCI presentation, "Become an Infusion Suites Coding Guru" (http://www.codingconferences.com/oncology08cds_doc_books.htm).