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Radiology Coding Alert

Reader Question:

Use Secondary ICD-9 for Metastases

Published on Tue Sep 23, 2003

Question: If a patient has cancer and the physician wants to evaluate for metastatic disease, which ICD-9 Codes should I report? I am trying to choose between V71.1 and V71.89 (Other specified suspected conditions). Should we include the word "suspected" on the claim? Ohio Subscriber Answer: You should report the ICD-9 code for the patient's current cancer as your primary diagnosis, and list V71.1 (Observation for suspected malignant neoplasm) as your secondary diagnosis. If the patient exhibits any other symptoms that led the physician to believe that her cancer had metastasized, you should report those as well. Leave the word "suspected" off of your claim. Proper ICD-9 coding dictates that you should never assign diagnoses for "possible," "suspected" or "rule-out" conditions.  
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