Wiki Diagnosing Melanoma

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dtricia

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I find coding for melanomas unclear in the code book. It is easy enough for the primary site, if it is skin, but secondary metastatic sites are not clear. I know it says for internal sites, code malignant neoplasm of that site. It does not reference metastases. If a pt has 'recurrence' in lung, axilly lymph nodes is it correct to use secondary codes from the neoplasm table?
Tricia D
 
"Secondary Code" is metastatic disease...

If the patient has a primary melenoma, the primary code will be 172._ what ever site the melenoma is at and then for a metastatic lung, 197.0, or metastatic axilla lymph node, 196.3.
 
Melanoma

Melanoma is not always 172.x In the code book index, very top Note-Except where otherwise indicated, the morphological varieties of melanoma in the list below should be code by the side as for 'Melanoma (malignant) Internal sites should be codes to malignant neoplasm of those sites.
And it gets more confusing if you have a metastatic melanoma of unknown primary....could be 199.1, 197.0. I have had conversations will providers about this and they agree with the coding.
Tricia
 
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