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Radiology Coding Alert

Reader Questions:

Stick to Secondary for Metastatic Tumor

Published on Thu Sep 10, 2009

Question: What is the difference between a primary and secondary neoplasm? I'm confused about which code to use for a metastatic tumor once the original tumor has been removed. Pennsylvania Subscriber Answer: Continue to report the metastatic tumor as "secondary" even if the primary tumor has been eradicated. Primary: A primary neoplasm code indicates the original tumor site. Secondary: A secondary neoplasm indicates a site to which the cancer has spread. History of: According to ICD-9 2009 official guidelines (www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/ftpicd9.htm), if the patient's tumor is eradicated and no longer requires treatment, you should use a "history of" code, such as V10.3 (Personal history of malignant neoplasm; breast). Here's the exact language: "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, a code from category V10, [...]
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