Oncology & Hematology Coding Alert

Have you heard the news about the new code set's implementation date?

The ICD-10-CM implementation date has been officially postponed and is no longer Oct. 1, 2013, according to a Feb. 16 statement from the Dept. of Health and Human Services (HHS). Although a new date hasn't been announced, you can take advantage of the extra time to ensure your practice has all of its preparations in place for the new coding and documentation requirements. Continue your training with this look at how coding for history of malignant colon neoplasm is expected to change.

With ICD-9-CM, you currently code personal history of colorectal cancer with V10.05 (Personal history of malignant neoplasm of large intestine).

ICD-10-CM difference: The ICD-10-CM code set includes Z85.038 (Personal history of other malignant neoplasm of large intestine) instead of V10.05. Bearing the same descriptor, except for the word "other" added in ICD-10-CM, you should regard Z85.038 the same way you do the ICD-9-CM code V10.05. The code definition for Z85.038 includes "other" to distinguish it from Z85.030 (Personal history of malignant carcinoid tumor of large intestine).

Documentation: According to ICD-10-CM, Z85.038 is applicable to conditions classifiable to code range C18 (Malignant neoplasm of colon), which includes:

• C18.0, Malignant neoplasm of cecum
• C18.1, Malignant neoplasm of appendix
• C18.2, Malignant neoplasm of ascending colon
• C18.3, Malignant neoplasm of hepatic flexure
• C18.4, Malignant neoplasm of transverse colon
• C18.5, Malignant neoplasm of splenic flexure
• C18.6, Malignant neoplasm of descending colon
• C18.7, Malignant neoplasm of sigmoid colon
• C18.8, Malignant neoplasm of overlapping sites of colon
• C18.9, Malignant neoplasm of colon, unspecified.

Coding tips: ICD-9-CM official guidelines state that you should use history codes (such as V10.05) "when a primary malignancy has been previously excised or eradicated from its site and there is no further treatment directed to that site and there is no evidence of any existing primary malignancy" (guidelines are available at www.cdc.gov/nchs/data/icd9/icd9cm_guidelines_2011.pdf).

ICD-10-CM official guidelines offer the same instruction for codes representing history of malignant neoplasm.

Additionally, a note with the Z85.- range states, "Code first any follow-up examination after treatment of malignant neoplasm (Z08)." Code Z08 (Encounter for follow-up examination after completed treatment for malignant neoplasm) includes "Medical surveillance following completed treatment."

Remember: When ICD-10-CM goes into effect, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.

To read HHS Secretary Kathleen Sebelius's statement about the postponed implementation, visit www.hhs.gov/news/press/2012pres/02/20120216a.html. And keep in mind "that even with a possible delay, practices should not put ICD-10 on the back burner," says Barbara J. Cobuzzi, MBA, CPC, CENTC, CPCH, CPCP, CPC-I, CHCC, president of CRN Healthcare Solutions, a consulting firm in Tinton Falls, N.J. The delay may not be long.