Oncology & Hematology Coding Alert

Question: Which ICD-9 code should I use when the doctor documents "tumor of the urothelium of the prostatic urethra"?

Florida Subscriber

Answer: If the tumor is malignant you should use 189.3 (Malignant neoplasm of kidney and other and unspecified urinary organs; urethra). However, if it's benign, use 223.81 (Benign neoplasm of urethra) instead.

Alternative: For a polyp of the urethra, use 600.20 (Benign localized hyperplasia of prostate without urinary obstruction and other lower urinary tract symptoms [LUTS]) or 600.21 (... with urinary obstruction and other lower urinary tract symptoms [LUTS]).

If you don't know the pathology of the tumor and are billing before the oncologist has interpreted the pathology report, you should use 239.5 (Neoplasms of unspecified nature; other genitourinary organs) to indicate the pending pathology.