Wiki Cancer-NED-On Meds - an any one please give clarification

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Meharaj Ahamad

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Hi. Coders

Can any one please give clarification on the below:

What code is to be coded when the document states:-"A patient had a malignant prostate neoplasm excised three years ago and has completed radiation and chemotherapy. Currently there is NED.however the pt is receiving continue treatment for prostate cancer with docetaxel."

Please do send in you response and ides in coding ICD 9 Code.
 
Since the Docetaxel treats the cancer you will code it as active cancer. To be history of the cancer you need to meet two criteria, that is NED, and no further treatment.
 
Hi

This is to my knowledge,If cancer status is given as NED,We were educated not to code cancer rather consider it as a Hx condition even though medication is given...What to code, can any one reply me?:)
 
I did reply, you are still treating the cancer with the drug therefore you must use the active cancer code and not history. To use history ex code for neoplasm you must have both criteria, NED and no treatment for the cancer.
 
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I found contradiction in above scenario as Cancer on NED and patient on drugs. This can be coded as History, as patient might be taking docetaxel for prophylaxis.

I hope this might help you!





Avinash Kumar, CPC
 
If it was being taken for prophylactic purpose then they did not have cancer. If the cancer has been successfully treated and they are taking the drug to suppress the cancer cells from recurring then it is coded as active cancer. Some call that prophylactic treatment but it is not. Prophylactic treatment is treating someone for cancer just because it runs strong in their family so it is prudent to treat them anyway.
 
As long as treatment is being received, then they are coded as active cancer. They have to 1) have no evidence of disease AND 2) not be receiving treatment to be coded as history of.

The same is true for women with breast cancer on Herceptin for 3 years or on oral hormone therapy, they are coded as active cancer since they are still receiving treatment.

Rhonda Crouch, CPC, CHONC
 
Cancer NED On Meds

My question is if we are a Radiation Therapy Free Standing clinic (only) and we treat the radiation part of this patient. Why would that patient be considered for our charges as "active"? The routine F/U visit the providers have stated "no evidence of disease" in our records indicate they are no longer are treating the patient with radiation therapy. Now I could see if our facility was associated with the Chemo Oncologist we would have code as "active" cancer if patient is on a maintenance therapy/hormonal therapy. So tell me what you would code in our case?

Thanks, Tami Wilson, CPC
 
You should have evidence in your records that the patient is still taking treatment. Is there correspondence between the two offices? Is the Docetaxel listed on the medication record? There may be NED for a radiological standpoint but if the patient is still taking chemotheray it should be coded as active disease.
 
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