Wiki ICD-9 for Focal Atypical Squamous Metaplasia of the bronchus and right middle lobe

[alannae]

I need help with a diagnosis for this patient. He had a suspicious mass seen on chest x-ray. Biopsy of the bronchus and right middle lobe returned with:

"moderate to moderately-severe active chronic bronchitis with focal atypical squamous metaplasia. No malignancy detected"

There is no mention of 'neoplasm' so I don't believe I can code as a benign neoplasm (212.3).

Metaplasia doesn't have any reference for 'lung' in the index.

Would I code as lung mass (786.6) even though we now have more information than just an unknown mass?

Or should I code as 518.89, other disease of lung, not elsewhere classified?

And code the bronchitis since it is not clearly a symptom of the metaplasia?

Thanks!

Alanna Esler, CPC

 

[mitchellde]

I would code it with a neoplasm of uncertain behavior.

 

[drsunitha]

As it is beningn noncancerous change of nonsquamous cells to squoamus cells ,as a response to chronic irritation, here it is chronic bronchitis which is trigerring the change.
I would code it 491.8, 518.89.