Urology Coding Alert
Renal Masses, Neoplasms and Tumors - Oh, My
Beware: Many commercial insurers, as well as Medicare, do not recognize 593.9 (Unspecified disorders of kidney and ureter) or 239.5 (Neoplasms of unspecified nature; other genitourinary organs)as acceptable diagnoses... Question:What's the distinction between a renal mass a neoplasm and a tumor? If the urologist just notes renal mass " how do I determine which diagnosis code to use? Our office has mixed opinions on this: One wants to code 593.9 and one wants to code 239.5.
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Answer: Do not report 239.5 (Neoplasms of unspecified nature; other genitourinary organs) for a renal mass. A note in the ICD-9 manual dictates that "the term 'mass' unless otherwise stated is not to be regarded as a neoplastic growth." A mass such as a mass in the kidney may mean many things including a malignant or benign process abscess cyst or even a normal but hypertrophied portion of the kidney.
If "kidney mass" is the only information you have code 593.9 (Unspecified disorder of kidney and ureter) is the most appropriate diagnosis. If a radiological study of the kidney discovers a renal mass but there is no conclusive diagnosis you can also report 793.5 (Nonspecific abnormal findings on radiological and other examination of body structure; genitourinary organs).
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