Wiki Coding for History of Breast Cancer

[Ethanzoe]

Should the V-Code for History of neoplasm of the breast or malignant neoplasm codes of the breast be used in follow up visits after a mastectomy or lumpectomy? I have been told that the malignancy should be coded for 5 years...and that if treatment is no longer being provided to the maligancy the History code of breast cancer should be used. Looking for which is the correct answer.
Thank you

 

[mitchellde]

The history code is used whenever there is no further treatment for the primary site and no evidence of disease. There is no set timeframe for this. However if the patient is receiving Tamoxifen or its equivalent then for as long as they are on the drug the cancer is considered active at the primary site. They can receive this drug for up to 10 years after all other treatment. Perhaps this is where your source became confused.
So if the patient is still undergoing radiation, chemo or drugs like tamoxifen then do not code history code, use the active breast cancer code. Even if the drug or radiation is not being administered at this encounter.

 

[Ethanzoe]

Thank you so much