Wiki History of bladder CA versus current dx

[ms123]

At what point do you code HISTORY OF BLADDER CA for cystoscopies versus the current CA diagnosis when patients come in for surveillance? An audit has prompted us to look further at this issue. Our urology doctors feel the patient always has CA and should always have the 188.9, etc. current codes. Some payers refuse to pay with the V-code. Please share how you treat this issue.

Thank you!!

 

[karansinghchauhan]

I think we should not use 188.9 but use a V code (history) in this case because patient has come for surveillance to check whether he has CA at this time or not.

 

[mlowe]

Bladder CA

I agree with the response. Pt's do not always have cancer at least it's not always active or progressive. You have to use the V code the visit should be paid for because it something that must be checked for recurrence at some point. My company has a rule of thumb when coding Cancers if it's not under treatment, or therapy, we literally treat it as history.