Oncology & Hematology Coding Alert

Watch out: Some of these answers don’t require an ICD-10 code at all.

When a patient details every brush with cancer their family ever had, you may be tempted to list each diagnosis—but not so fast. If you’re only scanning notes for “history of …” you might be missing the “no history of …” part.

We’ve put together a story for you. Fill in the blanks with the appropriate ICD-10-CM codes. Then check your answers below to see if you chose the correct codes.

Heads up: Be careful. Some of these are trick questions.

Read This History of Cancer Story

My family medical history includes a lot of cancer diagnoses. My mom spent years baking in the sun, and last summer her physician treated her for squamous cell carcinoma on her back (1. ___).

Her mom had uterine cancer. Apparently, there were so many overlapping tumors they couldn’t really tell where it started (2. ___).

Her father had several cancers, including non-Hodgkins lymphoma centered in his head and neck (3. ___), probably because he was part of the atomic bomb tests conducted by the military in the 1950s.

He used to joke that he wasn’t worried if he had to have an encounter for chemotherapy (4. ___) because he had already lost his hair.

His brother had pancreatic cancer that started in the head of the pancreas (5. ___). It was pretty advanced when they found it. It had already spread to his kidney (6. ___).

At one point, I felt a lump (7. ___) in the bottom-inside part of my left breast and was afraid the doctor would diagnose me with breast cancer (8. ___). Fortunately, I don’t have to say I have a personal history of breast cancer (9. ___) or family history of breast cancer (10. ___).

I worry about my dad because I think his mom had cancer, too. She had a mass in her lungs (11. ___). The family decided not to have it biopsied because she was already so sick.

We finally talked my dad into having a colonoscopy, and he had a clean bill of health. I don’t even have to say I have a family history of colon polyps (12. ___).

How Did You Do? Find Out Below

If you resulted in codes in the “C” section of ICD-10-CM, please verify the condition was that of the patient. If not, refer to the “Z” section for family history.

1. Z80.8 (Family history of malignant neoplasm of other organs or systems)

2. Z80.49 (Family history of malignant neoplasm of other genital organs)

3. Z80.7 (Family history of other malignant neoplasms of lymphoid, hematopoietic and related tissues) [already reported in #1]

4. You wouldn’t code this here, because it wasn’t a fact of the patient’s history.

5. Z80.0 (Family history of malignant neoplasm of digestive organs)

6. Z80.51 (Family history of malignant neoplasm of kidney)

7. None. You have no specific family history of a lump in the breast.

8. N63.24 (Unspecified lump in the left breast, lower inner quadrant)

9. None. No history of cancer means you don’t assign a code.

10. None. No family history of breast cancer means you don’t assign a code.

11. None. No history of cancer means you don’t assign a code.

12. None. No history of cancer means you don’t assign a code.

So the correct codes for the patient’s history above would include only: Z80.8, Z80.49 and Z80.7, Z80.0, Z80.51, and N63.24. So, how did you do?

Editor’s Note: Let me know your score on social media! (@SuzanneBWrites on Twitter or https://www.facebook.com/suzannebwrites/ on Facebook).