Wiki coding cancer HELP

[Chantell.Lee]

I have a resident who currently has gastic cancer... recently underwent a partial gastrectomy and has metastasis to the liver. This person also has a history of lung cancer (s/p chemoradiation treatment) with metastasis to lymph nodes, bones and liver and also has a history of bladder cancer. I am unsure what is primary and secondary and I'm not sure how to code history of a cancer that has metastasized... do i code each separately? I find coding cancer to be difficult... especially when the cancer is everywhere... any and all help is appreciated. Thank you

 

[StudentCPC11]

I have a resident who currently has gastic cancer... recently underwent a partial gastrectomy and has metastasis to the liver. This person also has a history of lung cancer (s/p chemoradiation treatment) with metastasis to lymph nodes, bones and liver and also has a history of bladder cancer. I am unsure what is primary and secondary and I'm not sure how to code history of a cancer that has metastasized... do i code each separately? I find coding cancer to be difficult... especially when the cancer is everywhere... any and all help is appreciated. Thank you

Sounds like there is a lot going on with this particular resident. Here are my thoughts:

Since the gastric cancer metastasized to the liver, perhaps that should be coded first, as this is the most recent area to be affected since undergoing the partial gastrectomy.

The lung cancer metastasis I was still working out in my head. I was thinking that perhaps the area the most affected (lymph nodes, bones or liver) should go first followed by those that become using the same degree of impact. I was thinking along the lines of how burns are coded by severity.

I am wondering about the history codes, if the lung came before the bladder or vice versa. Not sure if this would matter in regards to coding it.

Not sure if my thinking is even close coding wise on this, but again, this is what I was thinking might sort everything out. Hope it helped though.

 

[mitchellde]

I have a resident who currently has gastic cancer... recently underwent a partial gastrectomy and has metastasis to the liver. This person also has a history of lung cancer (s/p chemoradiation treatment) with metastasis to lymph nodes, bones and liver and also has a history of bladder cancer. I am unsure what is primary and secondary and I'm not sure how to code history of a cancer that has metastasized... do i code each separately? I find coding cancer to be difficult... especially when the cancer is everywhere... any and all help is appreciated. Thank you

Go one at a time:
Gastric cancer primary
Liver mets
Hx lung cancer
Lymph node mets
Liver mets (already coded)
Bone mets
Hx bladder cancer

Assign codes for each one

A metastatic site must always be coded with the primary, which can be acute or hx of. The code that goes first is either the most recent or that currently being treated.