Wiki 2N9 Location specificity

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Jones, MI
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We have a physician that is documenting 2N9 for the location of a breast malignancy. They say it means that it is at the 2 o'clock position, 9 cm from the nipple. I have searched and cannot find any official guidance on this. Does someone know if this is an "official" location language and if so what is it? I am hoping to create something for our facility that we can use this terminology for coding specificity.
Thank you!
Monica Evans
 
I don't know of official guidance on this, but the quadrants are easily correlated to the clock times. For example, 2 o'clock falls into the upper right quadrant of the clock (12 to 3 o'clock), so this would be the upper-inner quadrant of the right breast and the upper-outer quadrant of the left breast. Does that make sense?

I've always assumed that it was acceptable to use the clocks to identify locations since this seems self-evident to me, but perhaps someone can provide a reference. I haven't seen this particular notation though, so it might be a form of abbreviation that your practice should document in the event is was questioned by an auditor.
 
I don't know of official guidance on this, but the quadrants are easily correlated to the clock times. For example, 2 o'clock falls into the upper right quadrant of the clock (12 to 3 o'clock), so this would be the upper-inner quadrant of the right breast and the upper-outer quadrant of the left breast. Does that make sense?

I've always assumed that it was acceptable to use the clocks to identify locations since this seems self-evident to me, but perhaps someone can provide a reference. I haven't seen this particular notation though, so it might be a form of abbreviation that your practice should document in the event is was questioned by an auditor.
Thank you. I agree, that we can use clock position to determine what quadrant the mass was in. I just wasn't sure about this 2N9?
 
I also am unaware of any official guidance regarding allowable abbreviations. From anything I've seen, as long as the meaning of the abbreviation is clear in the context, I've never had an audit or anyone else restrict it's use. I do know for hospital records, most hospitals have a list of abbreviations that should never be used (particularly with medication names and dosing) as well as a list of approved abbreviations.

For example, in my practice, the clinicians use RA prior to a surgery description to indicate it is "robotic assisted" RA TLH BSO = robotic assisted total laparoscopic hysterectomy, bilateral salpingo-oophorectomy. For a rheumatology practice, it's going to mean rheumatoid arthritis. Hematology may use it for refractory anemia. It can definitely create confusion, or patient errors. But to my knowledge, for private practices, it is not prohibited.

I would also add with EHRs, it is usually easy to create user macros that if your clinician is tired of typing out an entire name, you can create a shortcut where the clinician enters just the abbreviation, but the medical record inserts the full name. But of course, that is in my own perfect world.
 
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