Wiki Current or Hx Of Malignancy

[SUEV]

According to ICD-9, if a patient is still receiving treatment to a malignancy site, it is considered a current malignancy, not a "history of". Would hormone therapy following a mastectomy for breast ca count as treatment directed to the site? The patient will be on hormone therapy for 5 years so would that actually qualify as treatment or would it be considered prevention? Should I use the 174 codes or the V10.3 code?

Thanks-Sue

 

[LLovett]

I would think it would be prevention. I would go with the V-code.

Laura, CPC, CEMC

 

[ruthan]

This is a tricky area for me as well. I work for a facility and do the lab/radiology coding. On many of the orders that I get it states as if the patient has the neoplasm now when for all i know it could actually be a history of the neoplasm. Unfortunately i do not get any more specific information so i code as a current neoplasm. I recently came across a order that stated the patient had ovarian cancer s/p chemo and s/p radiation. I emailed the forum and they advised I code the neoplasm and the V58.69 for the sp/chem-radiation.

How would you look at a order that stated patient had ovarian cancer and also endometrial cancer. order does not state if one is primary and the other is metastic. i code them both as primary....how are others doing this

I am so greatful for these forums and everyone's input. I have learned so much from all of you

 

[mitchellde]

If the patient is on Tamoxifen or its equivalent then it is still coded as current 174.9. If you look at the drug indications, if the indication states for cancer then you code the neoplasm as current. Such as Evista is for osteoporosis and is investigational for the prevention of recurrence therefor this would be coded as hx of cancer V10.3. Look at coding clinic May/June 1985 it has a ton of info on how to code neoplasm based on physician doc.