Oncology & Hematology Coding Alert

You Be the Coder:

Does Recurrence Change ICD-9 Option?

Question: How do you code recurrence of a tumor such as breast or lung? Is it a primary site? Alabama Subscriber Answer: For a recurrent tumor, choose the code based on whether the neoplasm is primary or metastatic. Watch the documentation for whether the recurrence is local or distant to decide which code is appropriate. Local: Locally recurrent means the tumor recurs at the original or primary tumor location. You should code this locally recurrent (or recurrent primary) tumor as a primary tumor of the stated site, according to AHA Coding Clinic for ICD-9-CM (May-June, 1985). For example, choose a primary breast neoplasm code such as 174.x (Malignant neoplasm of female breast ...). Distant: Distant recurrence comes back as metastases. If the cancer recurs as metastases, assign a metastatic code for the specified site, Coding Clinic says. For example, if the pathology report indicates metastatic recurrent carcinoma of lung, you [...]
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