Wiki metatastic squamous cell carcinoma

[maina03]

I am having difficulties with this dx... metatastic squamoous cell carcinoma, involving at least 7-9 lymph nodes... the lymph nodes are in the axilla area so I am not sure if I go with the metatastic code for the axilla 198.89 or with 173.82 for squamous cell.... some advice please...

 

[delphinus777]

If the pathology came back as metastatic SCC then i would code the 198.XX series. In the Coding guidelines [2013 ICD-9-CM book] under the official ICD-9-CM guidlines for coding and reporting, page 8 Chapter 2 Neoplasms; Treatment of secondary site; it states ......."When a patient is admitted because of a primary neoplasm with metastasis and treatment is directed toward the secondary site only, the secondary neoplasm is designated as the principle diagnosis....etc..."

 

[mitchellde]

axilla lymph node mets is coded as 196.3, if you do not have documentation of the location of the primary, you cannot assume skin you would need to code 199.1 for unknown primary.