Pathology/Lab Coding Alert

Question: Our pathologists examine lots of breast cases, so we're trying to prepare for diagnosis coding changes when ICD-10 takes effect, especially for malignancies. What differences should we expect?Virginia SubscriberAnswer: Using ICD-9, your coding options for primary breast neoplasms differ based on sex.For female patients you use 174.x (Malignant neoplasm of female breast), and your fourth digit options relate to anatomic location:174.0 -- ... nipple and areola 174.1 -- ... central portion 174.2 -- ... upper-inner quadrant 174.3 -- ... lower-inner quadrant 174.4 -- ... upper-outer quadrant 174.5 -- ... lower-outer quadrant 174.6 - ... axillary tail 174.8 -- ... other specified sites of female breast 174.9 -- ... breast (female), unspecified.For male patients, you use 175.x (Male neoplasm of male breast). The fourth digit again relates to anatomic site, but the list is much shorter:175.0 -- ...nipple and areola 175.9 -- ... other and unspecified sites of male breast.ICD-9 instructions for both 174.x and 175.x tell you to report an additional code [...]