'History of' for metastatic cancers

[AlainaMichelle]

Hello,

I'm an HCC coder and have an endocrinologist asking how he can code for personal history of a secondary cancer. The scenario is the patient had primary thyroid cancer that metastasized to lymph nodes. Both are now clinically NED. I believe we can code for personal history of thyroid cancer (V 10.87) and personal history of lymphatic cancers (V10.79). The physician beleives that V10.79 code is only for lymphomas and only for primary cancers. I see nothing that says the personal histories of have to be primary malignancies only. Is there a better way to code this situation?

For HCC coding these codes don't matter so much, but I'd like to give him a good answer.

What do you think? Thank you,

Alaina

 

[mitchellde]

YOur physician is Correct. The metastatic site is only an extension of the primary Cancer. This patient did have lymphoma they had thyroid cancer that extended to the lymph nodes now that they no longer have evidence of disease in the primary or secondary site it is just history of thyroid cancer. Do not assign history of lymphatic cancer as thIs patient has never had that particular disease.

 

[AlainaMichelle]

Thank you! That is very helpful and makes more sense to me now.