Wiki benign neoplasm

[Petlorilea]

It was my understanding that the neoplasm codes are not to be used unless/until pathology has been performed. I am in family practice, and when my providers refer to dermatology, they use a benign neoplasm code (for instance 216.9). There has never been a biopsy; they just deduce it is benign but have the patient consult with derm. I would rather that the unspecified code 709.9 be used.
Thoughts?
Thanks!

 

[kvangoor]

Could you use neoplasm of unspec. behavior?

 

[Petlorilea]

No, I believe that unspecified is when the pathologist considers the biopsy to be a tumor, but not is not specific.
I have it in my brain that all neoplasms need to be coded after pathology - even benign; I just can't lay my hand on the info...which could mean that I am mistaken. I don't know why every neoplasm category is dependent upon path EXCEPT benign. That throws all logic out the window for me

 

[mhstrauss]

Per ICD guidelines, Neoplasms of Uncertain Behavior are those of which histological confirmation of a specimen, whether the neoplasm is malignant or benign, cannot be made.

In your case, prior to biopsy/pathology, the Unspecified Behavior codes are correct.

Hope this helps!

 

[mitchellde]

Per ICD guidelines, Neoplasms of Uncertain Behavior are those of which histological confirmation of a specimen, whether the neoplasm is malignant or benign, cannot be made.

In your case, prior to biopsy/pathology, the Unspecified Behavior codes are correct.

Hope this helps!

The original post suggesting the 709.9 is correct. This cannot be uncertain behavior without a path report. Unpecified is defined in the ICD-9 Cm book:
The term "mass" ( when used in quotes like this it means mass and similar terms such as lump or bump or lesion, etc) is not to be considered a neoplastic process. If after a preliminary diagnostic the provider states tumr, or growth then we may code this as a neoplasm unspecified. So a skin lesion is 709.9.