quinn1234@tampabay.rr.com
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I work for a Hematology/Oncology practice. The patient was said to have Stage IV indolent low grade B-cell lymphoma with associated splenic and bone marrow involvement (due to progressive splenomegaly) and pancytopenia. The doctor marked it as an Extranodal marginal zone B-Cell lymphoma of MALT type and started him on Bendamustine + Rituximab and Peglilgrastim. The patient subequently underwent a splenectomy which pathology showed no evidence of lymphoproliferative disorder or evidence of malignancy. The patient now has a recurrence in the cervical nodes. I have two questions: First, should this have originally been coded as a NHL (C83.80), MZLS (C83.07) or Extranodal Marginal zone B-Cell Lymphoma, MALT type (C88.4)?
Second, since lymphomas are systemic, hey can be billed as a secondary disease, how should this recurrence be coded for the cervical nodes? Marginal Zone Lymphoma HFN (C83.01) or as one of the code listed above?
Please help! Thank you.