Otolaryngology Coding Alert

Question: Our hospital is arguing with our office that the primary diagnosis we reported for a patient, skin cancer of the nose (173.3), is incorrect and that we report the V51 code, an aftercare code, as primary. Can you please let me know if this is indeed correct?

Oregon Subscriber

Answer: The hospital seems to be mistaken. In fact, once a patient is diagnosed with cancer, he is considered to have cancer for as long as the American Cancer Society says it takes for the patient to be free of that typical type of cancer (number of years without a remission). Thus, you would report the cancer diagnosis (173.3, Skin of other and unspecified parts of face) as primary, and the V51 code (Aftercare involving the use of plastic surgery) would be secondary.

Since getting reimbursed for reconstructive services is hard enough, it would not be wise to exclude the reason for the defect, which is the cancer.