Home Health ICD-9/ICD-10 Alert
Start from the Top with Neoplasm Diagnosis
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Question: Our patient has been diagnosed with soft tissue Ewing’s sarcoma of the left leg with no bone involvement. When I reference "Sarcoma, Ewing’s" in the alphabetic index, I’m directed to "see Neoplasm, bone, malignant" but our patient’s cancer is not of the bone. How should I code for him?
Answer: You’re right that the entry next to "Sarcoma, Ewing’s" in the alphabetic index directs you to codes for neoplasms of the bone, but you missed another important detail when searching for your code.
If you look at the term "Sarcoma" in the alphabetic index at the very top of the list corresponding diagnosis codes, you’re advised to "see also Neoplasm, connective tissue, malignant." It’s under these search terms that you’ll find the correct code for your patient.
When you turn to the Table of Neoplasms and reference "Neoplasm, Connective Tissue, Malignant, Leg," you’re directed to code 171.3 (Malignant neoplasm of connective and other soft tissue; lower limb, including hip).
"Although Ewing’s sarcoma most commonly occurs in bone, it can also develop in soft tissue (called extra-osseous)," the American Hospital Association said in AHA Coding Clinic for ICD-9, Third Quarter 2012.
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Home Health ICD-9/ICD-10 Alert
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