Wiki How to code when 2nd is reason for TX

[rshumate]

We have a patient who has unknown primary and lung secondary.
The doctor is treating it as if it is a lung primary.
How should we code this for billing?

 

[christycic]

You would still code the lung secondary, but list it first since that is the primary treatment, and then list the unknown primary 2nd. Hope this helps

 

[cjacobs]

I would agree. I always code for the Mets first and then you code the primary source secondary. If primary source is unknown I would code 199.1 or you could leave blank. I have never had a problem with getting paide by insurance for just submitting a Mets dx only.

 

[lirby2005]

We have a patient who has unknown primary and lung secondary.
The doctor is treating it as if it is a lung primary.
How should we code this for billing?

Primary - 199.1
2Ndary - 197.0

Depending on what your physician's dictation, if he mentioned the unknown primary then you will have to code it with the 199.1 if nothing mentioned then 197.0 will do. I hope this help.

 

[lcashburn]

Like the others, I agree you always list what you are treating first, even if it is a secondary neoplasm. So you code the metastatic disease with the correct code, but in the first position, then list the primary in second position. And don't forget to code any additional signs or symptoms that come into play during the course of treatment!