The malignancy for which the therapy is being administered should be assigned as a secondary diagnosis. If a patient admission/encounter is for the insertion or implantation of radioactive elements (e.g., brachytherapy) the appropriate code for the malignancy is sequenced as the principal or first-listed diagnosis.
Full Answer
Which malignancy should be assigned as a secondary diagnosis?
The malignancy for which the therapy is being administered should be assigned as a secondary diagnosis.
How can secondary malignancies be prevented?
Preventing secondary malignancies involves avoiding these treatments that clearly increase the risk of second cancers and ensuring you do not receive too much treatment for your particular disease or risk factors. What are secondary malignancies?
What are secondary cancers?
Secondary cancers may occur months or years after treatment and are a consequence or side effect of the initial cancer treatment. For example, a patient with breast cancer or Hodgkin’s disease may develop acute leukemia years after completion of treatment for their first cancer.
What are the treatment options for secondary cancer after breast cancer?
Secondary cancers after breast cancer: The majority of women with localized early stage breast cancer are cured following treatment with: 1 Anthracyclines (doxorubicin, epirubicin, mitoxantrone). 2 Alkylating agents (cyclophosphamide). 3 Antimetabolites (5-FU, methotrexate). 4 Taxanes (Taxol®, Taxotere®).
When a patient is admitted for the management of an anemia associated with malignancy and the treatment is only for the anemia?
When the admission/encounter is for management of an anemia associated with the malignancy, and the treatment is only for anemia, the appropriate code for the malignancy is sequenced as the principal or first-listed diagnosis followed by code D63. 0, Anemia in neoplastic disease.
When a patient is admitted for management of dehydration due to a malignancy and only the dehydration is being treated the coder should?
When the admission/encounter is for management of dehydration due to the malignancy and only the dehydration is being treated (intravenous rehydration), the dehydration is sequenced first, followed by the code(s) for the malignancy.
When a patient is admitted because of a primary neoplasm with metastasis and treatment is directed toward the secondary neoplasm only?
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 principal diagnosis even though the primary malignancy is still present.
When a patient is admitted for chemotherapy for cancer what code is reported as the first-listed diagnosis?
11, Encounter for antineoplastic chemotherapy; or Z51. 12, encounter of antineoplastic immunotherapy as the first-listed or principal diagnosis.
When a patient is admitted to determine the extent of a malignancy or for a paracentesis or thoracentesis the?
f regarding admissions to determine the extent of malignancy includes the following: “When the reason for admission/encounter is to determine the extent of the malignancy, or for a procedure such as paracentesis or thoracentesis, the primary malignancy or appropriate metastatic site is designated as the principal or ...
How are primary and secondary cancers coded?
Note: There are codes for cancer of C80. 1 Malignant (primary) neoplasm, unspecified and C79. 9 Secondary malignant neoplasm of unspecified site. A diagnosis of metastatic cancer not otherwise specified (NOS) is used most often when diagnostic tests were not completed.
What is primary malignant neoplasm?
A malignant tumor at the original site of growth. [ from NCI]
What diagnosis code is reported for secondary neoplasm of the descending colon?
ICD-10 code C78. 5 for Secondary malignant neoplasm of large intestine and rectum is a medical classification as listed by WHO under the range - Malignant neoplasms .
What does malignant neoplasm of overlapping sites mean?
"Overlapping" implies that the sites involved are contiguous (next to each other). While numerically consecutive subcategories are frequently anatomically contiguous, this is not invariably so (for example bladder, C67). The coder may wish to consult anatomical texts to determine the topographic relationships.
When do you use Z51 89?
ICD-10 code Z51. 89 for Encounter for other specified aftercare is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
When do you code Z51 11?
The ICD-10 code for an evaluation prior to chemotherapy is Z01. 818 (encounter for examinations prior to antineoplastic chemotherapy). Z51. 11 is attached to the billing for the administration of chemotherapy so would not be used by the provider when the patient is going to a hospital-owned infusion center.
What is the ICD-10 code for metastatic cancer?
The 2022 edition of ICD-10-CM C79. 9 became effective on October 1, 2021. This is the American ICD-10-CM version of C79.
What is the primary malignancy code?
The primary malignancy is coded as an additional code. When a pregnant woman has a malignant neoplasm, a codefrom subcategory O9A.1-, Malignant neoplasm complicating pregnancy, childbirth, and the puerperium, should be sequenced first, followed by the appropriate code from Chapter 2 to indicate the type of neoplasm.
What is the code for pathological fracture due to a neoplasm?
When an encounter is for a pathological fracture due to a neoplasm, and the focus of treatment is the fracture, a code from subcategory M84.5, Pathological fracture in neoplastic disease, should be sequenced first, followed by the code for the neoplasm.
Can a patient have more than one malignant tumor?
Malignancy in two or more noncontiguous sites. A patient may have more than one malignant tumor in the same organ. These tumors may represent different primaries or metastatic disease, depending on the site. Should the documentation be unclear, the provider should be queried as to the status of each tumor so that the correct codes can be assigned.
What is secondary malignancy?
Secondary malignancies are cancers caused by treatment with radiation or chemotherapy. They are unrelated to the first cancer that was treated, and may occur months or even years after initial treatment. Some treatments increase the risk of developing a second cancer, such as the chemotherapy drugs etoposide, radiation therapy for some lymphomas and childhood leukemia, and treatment with both radiation therapy and chemotherapy together. Preventing secondary malignancies involves avoiding these treatments that clearly increase the risk of second cancers and ensuring you do not receive too much treatment for your particular disease or risk factors.
How many years after Hodgkin's disease do you get second cancer?
The risk of developing any second cancer was 10% at 20 years and 26% at 30 years. The younger the patient at the time of initial treatment and the use of radiation therapy were the most important factors for developing these cancers after Hodgkin’s disease treatment. [2]
What is chapter 2 of the ICD-9-CM?
General guidelines. Chapter 2 of the ICD-9-CM contains the codes for most benign and all malignant neoplasms. Certain benign neoplasms, such as prostatic adenomas, may be found in the specific body system chapters.
What is the code for neoplasm?
So for a patient who has a history of uterine cancer, with brain mets, receiving Radiation therapy I would code as such:#N#1) 198.3#N#2) V10.42 (If the patient has not received any treatment including oral meds for the uterine Ca in the past year)#N#3)V58.0#N#The Dx code 191.9 says this is a primary brain tumor not a metastatic tumor. If this truly is mets from the uterine cancer you should use the secondary code of 198.3#N#Hope this helps!
What is the code for anemia?
When the admission/encounter is for management of an anemia associated with chemotherapy, immunotherapy or radiotherapy and the only treatment is for the anemia, the anemia is sequenced first followed by code E933.1.
Should the neoplasm table be referenced first?
The neoplasm table in the Alphabetic Index should be referenced first. However, if the histological term is documented, that term should be referenced first, rather than going immediately to the Neoplasm Table, in order to determine which column in the Neoplasm Table is appropriate.
