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Wiki Neoplasm coding HELP...PLEASE!!!
- Thread starter fritzta
- Start date
whaleheadking
Guest
197.0 secondary malignant neoplasm of lung
198.5 secondary malingnant neoplasm of bone
Since you don't know the primary, there's no need to code it.
198.5 secondary malingnant neoplasm of bone
Since you don't know the primary, there's no need to code it.
mitchellde
True Blue
You must code the primary site with the secondary sites and if documented as unknown, then it is 199.1, I agree with the 197.0 and the 198.5 also.
FTessaBartels
Guest
Sequencing
Per ICD9 guidelines: If treatment is directed toward the secondary site only, the secondary neoplasm is designated as the principal diagnosis, even though the primary malignancy is still present.
In this case you don't even know the primary site, so I'd code 199.1 last.
F Tessa Bartels, CPC, CEMC
Per ICD9 guidelines: If treatment is directed toward the secondary site only, the secondary neoplasm is designated as the principal diagnosis, even though the primary malignancy is still present.
In this case you don't even know the primary site, so I'd code 199.1 last.
F Tessa Bartels, CPC, CEMC
mitchellde
True Blue
If the metastic site is "cured" then it is no longer coded. Remember the metastatic site is just the primary neoplasm in a different organ. This is why you always code the primary as either stil present , hx of or unknown. So if the mets to the lung is no longer present then code only the bone mets 198.5 with in this scenario 199.1 for the unknown primary. You sequence first that which is being treated on this encounter.
whaleheadking
Guest
I'm still not convinced that coding the primary is necessary given the lack of information. Adding 199.1 is saying that the pt has an active primary tumor as opposed to a history of cured cancer somewhere (V10.whatever). Lacking the documentation to say that the pt has active primary, I'm hesitant to apply it.
Mind you, I am approaching this from the Pathology Dept. where we usually have very little clinical information to work with.
Mind you, I am approaching this from the Pathology Dept. where we usually have very little clinical information to work with.