Oncology & Hematology Coding Alert
Set Treated Secondary Neoplasm in Primary Spot
Question: If colon cancer metastasizes to the brain and the patient presents for treatment of the brain cancer, should I report the colon cancer as the primary diagnosis?
Louisiana Subscriber
Answer: No--you should report the cancer being treated as the primary diagnosis, according to the official ICD-9-CM coding guidelines: -When a patient is admitted because of a primary neoplasm with metastasis and treatment is directed toward the secondary site only, the secondary neoplasm is designated as the principal diagnosis even though the primary malignancy is still present- (see www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdguide05.pdf).
Example: A patient's colon cancer (154.0, Malignant neoplasm of rectum, rectosigmoid junction, and anus; rectosigmoid junction) metastasizes to the occipital lobe of his brain (198.3, Secondary malignant neoplasm of other specified sites; brain and spinal column) and he presents for treatment of the brain cancer. Report 198.3 before 154.0.
Oncology & Hematology Coding Alert
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Make Use of V Codes for Mutations
Question: What diagnosis code should I report for a heterozygous MTHFR gene mutation?
Georgia Subscriber
Answer: [...] - READER QUESTIONS:
Set Treated Secondary Neoplasm in Primary Spot
Question: If colon cancer metastasizes to the brain and the patient presents for treatment of [...] - READER QUESTIONS:
Bite the Bullet--Report Only Highest Level Block
Question: May I report the professional component of 77333 for a bite block?
Illinois Subscriber
Answer: Code [...] - READER QUESTIONS:
Assign 36511-36516 for Apheresis
Question: We-ve recently begun performing apheresis for leukemia patients. How should we code this procedure?
Pennsylvania [...] - READER QUESTIONS:
Shed Light on Photodynamic Therapy Coverage
Question: Our oncologist recently started performing photodynamic therapy for esophageal cancer patients. How should we [...] - READER QUESTIONS:
Include Admin and Removal in 36550
Question: Does 36550 include the removal of Activase as well as the administration? The patient [...] - READER QUESTIONS:
Count Calls Toward E/M--Sometimes
Question: If my oncologist talks to a patient on the phone and communicates medical decision-making [...] - READER QUESTIONS:
Put ICD-10 Expectations on Ice
Question: Some of the coders in our oncology office have been talking about ICD-10. Are [...] - READER QUESTIONS:
Dig for More Info Than 'Left Arm Mass'
Question: What's the appropriate diagnosis code for -left arm mass-?
Oklahoma Subscriber
Answer: The most accurate [...]
