Wiki Cancer and Hepatitis Dx in patients with liver transplant.

[natashalage]

Hello,
Could you please tell me if I should code History of liver cancer, Hepatitis B in a patient who just received a liver transplant OR I should code these 2 conditions as they still exist? The MD who did a liver transplant is now managing immunosuppression for this patient. Prim DX is immunosuppressive therapy. The sick liver has been excised and replaced by a healthy one but did cancer and HBV become a History codes or still C22- liver cancer and B19- hepatitis? I attached 2 examples. Thank you very much for your help.

 

[natashalage]

Can someone please answer this question? Your help is greatly appreciated. Also, how can I submit this question (if unanswered) to AHA Coding Clinic? Thank you.

 

[rachaelwilleford]

If the primary cancer of the liver has been excised and is no longer receiving treatment for that, then it's a history of code. I would query the physician about the hepatitis and whether this is considered active or not. The physician would need to state the current status of the hepatitis.

 

[lgardner]

When you say the patient received a "liver transfer", do you mean transplant?

If so, the transplant status (Z94.4), should, probably be included.

ALSO, you say the primary dx is immunotherapy. NOT immunodeficiency?

 

[natashalage]

Thank you so much for your responses! Yes, they are liver transplant patients that are receiving immunosuppressive therapy (which is billable during 90day global surgery) as E/M-24. MD does not say it's a history of cancer, does not say ' no more liver cancer' which leaves me wondering if it's a history code or it still exists. Same puzzle with hepatitis B- all existed prior liver transplant but let's say 2 days ago, pt had a new liver (transplant). Does it make a History of cancer, History of hepatitis? Thank you for giving me some light on these scenarios.