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Radiology Coding Alert

Reader Question:

Cancer Diagnoses

Published on Thu Nov 01, 2001

Question: We recently saw a patient who was diagnosed with breast cancer, but the physician ordered a CT scan of the patients pelvis, abdomen and chest to check for metastases. Should we use the primary site of the cancer as the diagnosis code or is there a better option?
 
Tennessee Subscriber  
Answer: Diagnosis coding in this instance may depend on a variety of factors. If the patient is being treated for breast cancer, assign the breast-cancer code as the primary diagnosis (174.9, malignant neoplasm of female breast; breast [female], unspecified). If the course of treatment has been completed, V10.3 (personal history of malignant neoplasm; breast) should be reported.
 
Sometimes, the CT scans may be prompted by specific signs or symptoms like bone pain. The studies may then be reported with 733.90 (disorder of bone and cartilage, unspecified), with 174.9 reported as the secondary reason for the encounter.
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