Wiki Radiation Therapy Diagnosis Coding/Sequencing

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egraham1827

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There has been a lot of discussion in my office about how to properly sequence diagnosis codes for radiation therapy. The ICD-9 guidelines are not black and white when it comes to treating a metastasis. For treatment directed at a secondary site, it only states that the treatment site is the principal diagnosis (which we of course agree with); however, it does not state whether the primary site also needs to be on the claim as the second dx code. Most of my co-workers are not coders so it is difficult to explain to them why we also need to put the primary site on the claim when that is not the area we are treating.

So the question is: When treating a metastatic site, does the primary site also need to be on the claim, whether still active or not? Any clarification/guidance on this would be greatly appreciated!! If you can provide your source as well that would be helpful so I can take the information to my supervisor.

Thank you in advance for your help!!! :)
 
The primary dx when the treatment is radiation or chemo is the V 58.1 code which is first only allowed. The secondary code is the the neoplasm or site being treated. It was a coding clinic I ready several years back possibly 2000 or even earlier that the secondary site must be accompanied by its primary neoplasm code to identify the type of neoplasm. And it could be still active or history of.
 
Yes I also agree w/ the V58x code as primary, but again that is an issue here lol. Thank you for your input, I definitely agree! :)
 
The coding guidelines are your backup for using the V 58.1- code first listed, along with page one paragraph 3 of the guidelines that state these are mandated to be followed under HIPAA
 
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