Oncology & Hematology Coding Alert
Lymph Node Coding
New Jersey Subscriber
Answer: Mycosis fungoides, a type of cutaneous, T-cell lymphoma, may evolve into generalized lymphoma, formerly thought to be fungoid in origin. It is usually present in lymph nodes. This diagnosis always requires a fifth digit that defines lymph node or spleen involvement.
The fifth-digit subclassification is used specifically for malignant neoplasms of lymphatic and hematopoietic tissue (200-208). These subclassifications should not be used with secondary neoplasm of bone marrow (198.5), spleen (197.8), or secondary and unspecified neoplasm of lymph nodes (196.0-196.9)
Note: See CPT 2002 for a full description of fifth-digit subclassifications.
In your situation, if there is no lymph node involvement or no spleen involvement (202.17), it is correct to code 202.10.
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