Wiki cancer recurrance in prostatic fossa

[JTE79]

Patient had radical prostatectomy 15 years ago and now has a recurrance in the prostatic fossa. How should this be coded using ICD9.
198.82 secondary malignancy to other sites; genital organs with V10.46 History of prostate cancer or 185 malignant prostate/

 

[mitchellde]

Yes code the prostate as history of since the prostate was removed it can no longer be an active primary, code the present location as metastatic.

 

[emcee101]

This is an interesting topic and one that you will ultimately need more info from the physician. Although the patient had a radical prostatectomy, that does not mean that there cannot be a recurrence of prostate cancer. I posted a link to a clinical study below which details that roughly one-third of radical prostatectomies fail for clinical localized prostate cancer.

I worked 6 years coding in a large urology practice and have seen numerous cases (including a mamber of my family) where a patient has a radical prostatectomy and then a recurrence of PCa. Not all of these cases are true prostate cancer (some can be mets to the lymph nodes surronding) but most are coded to 185 for prostate cancer.


http://pubs.rsna.org/doi/full/10.1148/radiology.219.2.r01ma20432