Oncology & Hematology Coding Alert

READER QUESTIONS:

Treat 2 Areas, Double Neoplasm Dx

Question: Which diagnosis codes should I report when a patient presents for radiation therapy treating squamous cell carcinoma of the posterior hypopharyngeal wall as well as metastasis to cervical lymph nodes?

Alabama Subscriber

Answer: You need to list the radiation therapy encounter first (V58.0, Encounter for other and unspecified procedures and aftercare; radiotherapy).

Because treatment is directed at both the primary malignancy and the metastatic sites, you should code both:

" 148.3 -- Malignant neoplasm of hypopharynx;posterior hypopharyngeal wall

" 196.0 - Secondary and unspecified malignant neoplasm of lymph nodes; lymph nodes of head, face,and neck.

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