Pulmonology Coding Alert

Question: We saw a 36-year-old female patient who had successful treatment of cancer of the right bronchus several years ago. She visited our office for testing to confirm that her lungs are healthy before she talks to her ob-gyn about the possibility of trying to get pregnant. Do we report the cancer diagnosis?

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Answer: In the absence of any signs, symptoms or patient complaints, your most likely code will be Z85.118 (Personal history of other malignant neoplasm of bronchus and lung) because the reason for this exam is not preventive. Instead, it is medically indicated as surveillance because the patient’s history of cancer makes her potentially at risk of recurring lung issues.

In the ICD-10 manual, prior to the listing of the Z85 code range, it says “Code first any follow-up examination after treatment of malignant neoplasm.” Therefore, you should report Z08 (Encounter for follow-up examination after completed treatment for malignant neoplasm) and list it before Z85.118 on your claim. Be sure to review your payer policies to see if Z08 is a recognized code. Certain payers may require you list Z85.118 as the primary dx.