Oncology & Hematology Coding Alert

Question: My oncologist reported "possible lymphoma" as the diagnosis for one of his patients. What in the chart will indicate if there is actually lymphoma or whether I need to code the signs and symptoms? Florida Subscriber Answer: Rule 1 of proper ICD-9 coding: Never assign diagnosis codes for "possible," "suspected" or "rule-out" diagnoses. Before you decide how you are going to code this situation, first ask your physician if there is a specific diagnosis of the patient's condition or if he has not pinpointed the source of the symptoms. From the information you provided, it sounds as if the oncologist was not able to diagnose the patient, which means you will have to report diagnosis codes for the signs and symptoms the patient presented with. Some of the more common signs of non-Hodgkin's lymphoma include a painless swelling of one or more of the lymph nodes (neck, armpits, etc.), chest pain, respiratory difficulties and even many symptoms of influenza, mononucleosis, tuberculosis or other cancers. Answers to the Reader Questions and You Be the Coder were provided by Margaret M. Hickey, MS, MSN, RN, OCN, CORLN, an independent coding consultant based in New Orleans; and Linda L. Lively, MHA, CCS-P, RCC, CHBME, founder and CEO of American Medical Accounting and Consulting in Marietta, Ga.