Oncology & Hematology Coding Alert

Question: I was unable to find a myeloma diagnosis in the neoplasm table. Am I looking in the wrong place?


Wyoming Subscriber

Answer: Although you-ll find help coding most neoplasms in the ICD-9 manual's neoplasm table, myeloma codes are listed in the alphabetic index instead.

Example: Your report indicates multiple myeloma. Because you can't locate -myeloma- in the neoplasm table, you look at the alphabetic index, which points you to 203.0. You turn to the entry for 203.0x (Multiple myeloma) in the tabular list and discover you need to choose a fifth digit to code this diagnosis to the greatest specificity. The report doesn't mention remission, so you report 203.00
(... without mention of remission).

Note: Melanoma diagnoses are also found in the index rather than the neoplasm table. 

Example: Your patient's diagnosis is malignant shoulder neoplasm. The neoplasm table entry for -melanoma- is -See Melanoma.- You look up -Melanoma- in the alphabetic index, which indicates 172.6 for shoulder melanoma. You check the tabular index and determine 172.6 (Malignant melanoma of skin; upper limb, including shoulder) is the correct code for your claim.