Urology Coding Alert

Deciding which code depends on the documentation.

As you read in “Determining When 188.x Becomes V10.51 Depends on Exam Findings,” you’ll need to scour your urologist’s documentation to figure out if a patient has active bladder cancer or just personal history of bladder cancer. The good news is that when you have to start using ICD-10 on Oct. 1, 2014, you won’t have to alter your process at all.

Focus on 1-to-1 Conversion For 188.x

When ICD-10 goes into effect next year, you shouldn’t have too much trouble updating your bladder tumor coding. You’ll have a one-to-one correlation between the codes, as follows:

• 188.0 (Malignant neoplasm of trigone of urinary bladder) will become C67.0 (Malignant neoplasm of trigone of bladder)
  
• 188.1 (Malignant neoplasm of dome of urinary bladder) will become C67.1 (Malignant neoplasm of dome of bladder)
  
• 188.2 (Malignant neoplasm of lateral wall of urinary bladder) will become C67.2 (Malignant neoplasm of lateral wall of bladder)
  
• 188.3 (Malignant neoplasm of anterior wall of urinary bladder) will become C67.3 (Malignant neoplasm of anterior wall of bladder)
  
• 188.4 (Malignant neoplasm of posterior wall of urinary bladder) will become C67.4 (Malignant neoplasm of posterior wall of bladder)
  
• 188.5 (Malignant neoplasm of bladder neck) will become C67.5 (Malignant neoplasm of bladder neck)
  
• 188.6 (Malignant neoplasm of ureteric orifice) will become C67.6 (Malignant neoplasm of ureteric orifice)
  
• 188.7 (Malignant neoplasm of urachus) will become C67.7 (Malignant neoplasm of urachus)
  
• 188.8 (Malignant neoplasm of other specified sites of bladder) will become C67.8 (Malignant neoplasm of overlapping sites of bladder)
  
• 188.9 (Malignant neoplasm of bladder part unspecified) will become C67.9 (Malignant neoplasm of bladder, unspecified).
  

1 Code Replaces V10.51, Too

For patients that no longer have active bladder cancer, you currently use V10.51 (Personal history of malignant neoplasm of bladder). Under ICD-10, you’ll still have just one code to identify patients with history of bladder cancer: Z85.51 (Personal history of malignant neoplasm of bladder).

Physician documentation: Your urologist should already be documenting the specifics of the type and location of the patient’s bladder tumor, and for the most accurate ICD-10 coding you should encourage your urologist to continue being specific on every encounter and procedure note.

Superbill updates: While you won’t need to make more room for these codes on your superbill in 2014, you still must update the sheet with the new diagnosis codes.