Wiki Cancer dx vs. History of dx

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karey

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When is a cancer dx converted to a "history of" dx? I have a patient w/ NED (no evidence of disease) for 6 years. I had been told in the past that if no reoccurance of cancer after 5 years its no longer an "active" cancer so do I still use the cancer dx or change the dx to a "history of"??
 
You use the hx of codes as soon as all treatment has ceased and the provider documents NED. If the patient has Breast or prostate cancers these are treated long term after all other treatments have ceased so for those even if the provider states NED, you must look to see if they are being treated with long term therapy to suppress active cancer cells, such as Tamoxifen or Lupron, then it is not hx of it is active. So depending on your patients cancer and current treatment , it is probably hx of.
 
Once the doctor states NED then does he/she use the "history of" code for that last visit or do they only use it if the patient comes back for another problem? I ask because my docs are GYN/ONC and they will treat the patients and then release them back for normal f/u care through their regular GYN or PCP. Generally if they come back its because of reoccurance.
 
ok. Do you know where I can find some literature on the coding? I have been looking for well over an hour trying to find something w/ no luck. I found an article from the ACS stating that 5 years after the stop of treatment w/out reoccurance is considered NED but nothing on coding.
 
Another question...

Another question to get clarification... if a plastic surgeon is doing a breast reconstruction, either immediately following the mastectomy or delayed, or further repair, such as tissue expander replacement, etc. , how would you code the ICD-9 in these cases? Would you code the cancer, hx of cancer or what?

Thanks,
 
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