Sequence These 2 Codes for Myxofibrosarcoma IMRT
Question: A patient came in for intensity-modulated radiotherapy (IMRT) to treat myxofibrosarcoma of the left calf. The payer is asking for another diagnosis code. What should I give them? AAPC Forum Participant Answer: In this situation, you will need two diagnosis codes. Your question assumes you gave them a diagnosis code for the myxofibrosarcoma, which is a soft tissue sarcoma that affects connective tissues in the arms and the legs. The most specific code you can use for this condition would be C49.22 (Malignant neoplasm of connective and soft tissue of left lower limb, including hip). However, that is not the only code you will need to provide in this scenario. As the patient is being treated at the encounter, you will also need to add a code for the IMRT, which in this case would be Z51.0 (Encounter for antineoplastic radiation therapy). Further, per ICD-10-CM guideline I.C.2.e.2, “if a patient admission/encounter is chiefly for the administration of chemotherapy, immunotherapy or external beam radiation therapy assign code Z51.0, Encounter for antineoplastic radiation therapy, or Z51.11, Encounter for antineoplastic chemotherapy, or Z51.12, Encounter for antineoplastic immunotherapy as the first-listed or principal diagnosis.” This means the correct coding for the encounter would be Z51.0 as the first-listed diagnosis followed by C49.22. Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC
