Wiki Dx cancer coding help

[Tonyj]

Cancer codes always give me a hard time. Can anyone assist me with these diagnosis codes? I can use a code given by the path report but what about the mets? Thanks in advance. Please read below.

Physicians Note: 10/1/10
CT- extensive mets. Diagnosed with metastatic carcinoma most consistent with urothelial primary.
What Dx code should I use???

History: pt had renal cell carcinoma 1996 (removed by nephrectomy); Melanoma L arm - resected in 02/2009 (superficial spreading- 0.75 mm)

As per cytopathology report: ICD9 Codes: 198.5
CLINICAL INFORMATION:
History of melanoma and right nephrectomy for ureteral tumor.
Now with apparent metastatic lesions.
Findings:
Bone, left ilium (CT-guided fine needle aspiration):
Metastatic carcinoma, most consistent with urothelial
primary (see comment).

Cell Block Study: Metastatic carcinoma, most consistent
with urothelial primary.

Tonyj

 

[kbazarte@yahoo.com]

for the renal cell ca the code would be V10.52 from the info given stating history not current malignancy

the melanoma would also be a history code V10.82

the bone mets would be 198.5 as the primary code followed by V10.52 ans V10.82

 

[Tonyj]

Thanks for your response.
Do I also code the urothelial primary?

Tonyj

 

[boozaarn]

you do not code "consistent with"

I think that you should code it this way
198.5; V10.52; v10.82;v45.73 and v45.89