Oncology & Hematology Coding Alert

Question: When the patient has had a DCIS diagnosis (233.0), how do you code for the “history of DCIS”? I am a bit hesitant to use the V10.3 diagnosis for history of breast cancer.

Minnesota Subscriber

Answer:  You should use V13.8 (Personal history of other specified diseases) to report a history of ductal carcinoma in situ (DCIS), according to AHA’s ICD-9 Coding Clinic, First Quarter, 2012. The complete code is V13.89.

Coding Clinic specifically states that V10.3 (Personal history of malignant neoplasm of breast) would not be appropriate for history of DCIS. The reason given is that DCIS is “not classified as a primary malignancy. Code V10.3 is reserved for personal history of ‘primary’ breast malignancy for conditions classifiable to 174 and 175, as the inclusion note under V10.3 indicates.”

Currently, DCIS is coded to 233.0 (Carcinoma in situ of breast) rather than to 174.x (Malignant neoplasm of female breast) or 175.x (Malignant neoplasm of male breast).

ICD-10-CM: When ICD-10-CM becomes effective Oct. 1, 2014, you will be able to report Z86.000 (Personal history of in-situ neoplasm of breast) when documentation indicates a personal history. Or choose from the following codes for DCIS:

·         D05.10, Intraductal carcinoma in situ of unspecified breast

·         D05.11, Intraductal carcinoma in situ of right breast

·         D05.12, Intraductal carcinoma in situ of left breast.