Pathology/Lab Coding Alert

Question: We have a pathology report for a right ovary biopsy with a diagnosis of “invasive epithelial carcinoma.” The surgeon requesting the biopsy exam stated that the patient exhibited hyperestrogenism. What is the correct diagnosis coding for this case?

Mississippi Subscriber

Answer: The pathologist’s diagnosis statement describes a malignant neoplasm of the right ovary. That means you should report C56.1 (Malignant neoplasm of right ovary). An ovarian epithelial tumor is a type of cancer that begins in the outer tissue layer of the ovary, as opposed to germ cell tumors originating in the cells that produce the eggs, or stromal tumors that originate in the cells that produce hormones.

ICD-10 code C56 instructs you to “use additional code to identify any functional activity.” Because the surgeon documented hyperestrogenism, which is apparent in the pathology report, you should also code E28.0 (Estrogen excess).