Wiki Lymphoma's -HELP!!!

[KMayercsik]

Hi All!
Patient presented with a primary CNS lymphona in 2012. A recent MRI shows lesions in the brain, frontal lobe and occiptal lobe, and refers to 'metastatic disease'. Would this be coded as immunoproliferative neoplasms in relapse? Help!!!!!

 

[Tonyj]

Hi All!
Patient presented with a primary CNS lymphona in 2012. A recent MRI shows lesions in the brain, frontal lobe and occiptal lobe, and refers to 'metastatic disease'. Would this be coded as immunoproliferative neoplasms in relapse? Help!!!!!

Primary CNS lymphoma is coded as 200.5x, 5th digit used for site. I'm not understanding where you're getting the "immunoproliferative neoplasms in relapse". Was there any documentation stating the pt was in remission? In any case code selection should be what is being addressed at that days visit. 200.5X, 198.3 (2ndary malignant neoplasm brain and spinal cord) or vice versa.

 

[KMayercsik]

Lymphoma

Hi Tony;
The patient was in remission per a CT on 2/27/13 and documented by the MedOnc. A recent MRI is showing several brain lesions. In 2011 he was treated and the path shows diffused large B Cell brain, which I thought should be 202.80. The MedOnc coded it 200.50They referred him to us (RadOnc) due to several lesions in the brain. Would the code continue to be 202.80? The medoncs coded it 203.82, which is where I am coming up with that code.

 

[Tonyj]

Hi Tony;
The patient was in remission per a CT on 2/27/13 and documented by the MedOnc. A recent MRI is showing several brain lesions. In 2011 he was treated and the path shows diffused large B Cell brain, which I thought should be 202.80. The MedOnc coded it 200.50They referred him to us (RadOnc) due to several lesions in the brain. Would the code continue to be 202.80? The medoncs coded it 203.82, which is where I am coming up with that code.

I see what you're saying. I don't know where 203.82 is coming from. I'm on the fence between 200.50 and 202.80, leaning more toward 200.50 but 198.3 should be your primary if that's what you're treating. Lymphomas are so fun to code aren't they?