Radiology Coding Alert

Question: We sometimes perform tests on patients who are in cancer remission. When should we replace the cancer diagnosis with a "history of cancer" diagnosis code?

Pennsylvania Subscriber

Answer: Although cancer registries typically prefer that five years elapse before removing a cancer diagno-sis, that rule does not apply to physician ICD-9 Coding.
 
If the patient is cancer-free, you should use a personal history of cancer diagnosis for any procedure that you subsequently report. The American Hospital Association's Coding Clinic guidelines state that you should report "history of malignancy" once a physician has removed or eradicated a tumor, when treatment is no longer directed to the tumor site and when there is no evidence of remaining malignancy. At that point, you should report the appropriate V10.x code (such as V10.52, Personal history of malignant neoplasm of kidney) as your diagnosis code for these visits.