Brachytherapy & coding active vs Hx of CA

[ddeangelis]

I've had numerous physicians inquire what diagnosis code they should select for patients that have had "permanent-type" brachytherapy (say for prostate cancer or uterine cancer). When first inserted, the radiation dosage is high however over time, the dosage will decrease to eventually read zero. The question that keeps coming up is: "If permanent brachy seeds are in a patient who was treated for prostate cancer 2 years ago and I'm seeing him today for a follow up visit, should I use the active cancer code 185 indefinitely or history of cancer code V10.46? And what would define when to switch from active CA to Hx of CA since radioactive seed values vary upon the tumor cell type and aggressiveness?"
I've searched the Internet as well as the AHA coding clinic and can't find much at all addressing this. If you could kindly include any reference links with your response or AHA coding clinic references, I would greatly appreciate it.
Thanks for your time

 

[mitchellde]

The provider needs to indicate the seeds are currently inactive and the patient has no evidence of disease in the primary location

 

[ddeangelis]

Thanks Debra. So basically for primary care physicians, if there is no report from a radiation oncologist indicating "zero gray units" from implanted brachytherapy seeds, the patient should be considered in active treatment and coded as having active cancer until there is documentation either from the radiologist or oncologist to indicate the patient is cancer-free.

 

[mitchellde]

I would accept that as a correct statement.