Primary Care Coding Alert

Don't expect code descriptor changes when new system kicks off.

A personal history of colon cancer can significantly impact a patient's risk for future disease, so be sure you're up-to-date on how to accurately capture the history with diagnosis codes.

Under ICD-9, you currently code personal history of colorectal cancer with a single code: V10.05 (Personal history of malignant neoplasm of large intestine).

ICD-10 difference: When ICD-9-CM shifts to ICD-10-CM, code V10.05 will change to Z85.038 (Personal history of other malignant neoplasm of large intestine). The code will retain the same descriptor -- except for the word "other" added in ICD-10. The word "other" helps distinguish Z85.038 from Z85.030 (Personal history of malignant carcinoid tumor of large intestine).

Documentation: According to ICD-10-CM, diagnosis Z85.038 is applicable to conditions that fall under parent code C18 (Malignant neoplasm of colon). More detailed options in the code family include:

• C18.0 -- Malignant neoplasm of cecum
• C18.1 -- Malignant neoplasm of appendix
• C18.2 -- Malignant neoplasm of ascending colon
• C18.3 -- Malignant neoplasm of hepatic flexure
• C18.4 -- Malignant neoplasm of transverse colon
• C18.5 -- Malignant neoplasm of splenic flexure
• C18.6 -- Malignant neoplasm of descending colon
• C18.7 -- Malignant neoplasm of sigmoid colon
• C18.8 -- Malignant neoplasm of overlapping sites of colon
• C18.9 -- Malignant neoplasm of colon, unspecified.

Coding tip: ICD-9 guidelines state that you should use history codes (such as V10.05) as the reason for an encounter when a condition needs to be monitored for recurrence. You'll follow the same guidelines for history codes when ICD-10 begins.