Oncology & Hematology Coding Alert

Be sure documentation clearly distinguishes bone from bone marrow metastases.

ICD-10 will double your coding options for secondary neoplasms of bone and bone marrow.

ICD-9: Under ICD-9 2011, you report 198.5 (Secondary malignant neoplasm of other specified sites; bone and bone marrow) to indicate the confirmed presence of cancer that has spread from a different (primary) site to the bones or bone marrow.

ICD-10: The new code set, planned to take effect Oct. 1, 2013, instead may offer two distinct codes:

• C79.51, Secondary malignant neoplasm of bone
• C79.52, Secondary malignant neoplasm of bone marrow.

Documentation: The switch to two separate codes means that clear confirmation of whether the bone or bone marrow is involved will be crucial to your ability to choose the proper ICD-10 code.

Coder tip: Both ICD-9 and ICD-10 provide alternate codes for secondary neuroendocrine tumors. Under ICD- 9, you use 209.73 (Secondary neuroendocrine tumor of bone). ICD-10 includes C7B.03 (Secondary carcinoid tumors of bone). Both ICD-9 and ICD-10 instruct you to use an additional code to provide more information on the diagnosis.

Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.