Oncology & Hematology Coding Alert

Question: Can you explain how to report estrogen receptor status? Must you report a breast neoplasm diagnosis as primary or secondary with V86.x? Connecticut Subscriber Answer: Yes, you should report a breast neoplasm code (either 174.x, Malignant neoplasm of female breast; or 175.x, Malignant neoplasm of male breast, as appropriate) as the first-sequenced diagnosis with V86.x (Estrogen receptor status). When you look up V86.x in the ICD-9 manual, you are instructed to "Code first malignant neoplasm of breast (174.0-174.9, 175.0-175.9)." Example: For a female patient with a malignant breast neoplasm and estrogen receptor positive status, you should report the neoplasm (174.x) and then the estrogen receptor status with V86.0 (Estrogen receptor positive status [ER+]). For negative status, you would report 174.x for the neoplasm and then V86.1 (Estrogen receptor negative status [ER-]). Go to the source: For complete information on reporting V86.x, you can view the official guidelines in Section 1.C.18.d.3. of the ICD-9 manual or online at http://www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdguide08.pdf. -- Technical and coding advice for You Be the Coder and Reader Questions provided by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and past president of the American Academy of Professional Coders National Advisory Board.