Wiki Uncertain primary/secondary malignancy

[bbooks]

Am I coding this correctly?

I have a path report for a skin lesion that overlaps 2 sites (canthus and scalp) and is undetermined whether it is primary or secondary. In addition, the primary site is undetermined (the patient has a history of 2 different kinds of cancer). From what I read, instructions are to code the first uncertain lesion as a primary and then include an additional code for the primary site (which is also uncertain).

173.80
199.1

 

[BlakeCarswell82]

According to Dennis Padget, it is appropriate as uncertain behavior when the pathologist is unsure whether the specimen is primary or secondary.

 

[bbooks]

Thanks. In digging through Padget's further, he recommends that the primary source NOT be coded with the secondary malignancy. Therefore, I have decided to remove the 199.1 code.

 

[BlakeCarswell82]

I had this exact question just a couple weeks ago.