Oncology & Hematology Coding Alert

Question: We have a patient with nodular lymphoma that our oncologist has documented as in remission. Can we continue to report diagnosis code 202.01, or do we have to report a "history of" code? Also, what are the guidelines on the five-year rule for cancer remission?

Nevada Subscriber

Answer: You should not report a "history of" diagnosis code, but continue to report 202.01. Medicare and other carriers consider lymphoma patients in remission to still have lymphoma.
 
Remember, however, that no official five-year rule, or any other time period, for cancer remission exists when determining the assignment of malignancy or "history of" codes. In that case, as soon as your oncologist stops treating the patient, and your physician considers the malignancy eradicated, you should begin using "history of" codes.

 - Answers to Reader Questions and You Be the Coder were provided by Linda L. Lively, MHA, CCS-P, RCC, CHBME, founder and CEO of American Medical Accounting and Consulting in Marietta, Ga.; Margaret M. Hickey, MS, MSN, RN, OCN, CORLN, an independent coding consultant based in New Orleans; and Cindy Parman, CPC, CPC-H, RCC, principal and co-founder of Coding Strategies in Atlanta.