Question Coding for Lymphoma

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I have a question concerning how to code for Lymphoma. All information indicates that Non-Hodgkin's Lymphoma is a "chronic condition" and should be coded from the "C" section of ICD10. There are no "remission" codes but there is a "Z" code for "Personal History of". I am confused with the information as it seems to contradict itself, once you have this type of Lymphoma there is no cure, though you receive treatment and it can go into a "remissive state", you always have it. I am interpreting this info as you should always code it as "active". Does anyone have any other information or guidelines pertaining to this? Thoughts? Thank You! Jennifer - Coding Analyst
 

trarut

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You are correct that Lymphoma is a systemic disease so you have always have it. Lymphomas are coded from the C81 to C88 categories in ICD-10. I was taught to code it active based on the current or most recent site(s) of disease and to never be coded to history UNLESS the physician specifically states that the patient is completely disease-free or cured - which I've only seen twice in the 25 years I've been coding (20 years in Oncology) and both of those were in patients who had gone through treatment, were completely asymptomatic and had been free of recurrence for 15+ years.

I don't have any references currently available that I can upload but I have found the Coding Strategies Navigator for Oncology Diagnosis Coding to be extremely helpful as a reference tool in general.
 
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You are correct that Lymphoma is a systemic disease so you have always have it. Lymphomas are coded from the C81 to C88 categories in ICD-10. I was taught to code it active based on the current or most recent site(s) of disease and to never be coded to history UNLESS the physician specifically states that the patient is completely disease-free or cured - which I've only seen twice in the 25 years I've been coding (20 years in Oncology) and both of those were in patients who had gone through treatment, were completely asymptomatic and had been free of recurrence for 15+ years.

I don't have any references currently available that I can upload but I have found the Coding Strategies Navigator for Oncology Diagnosis Coding to be extremely helpful as a reference tool in general.
Thank you very much for your reply, it confirms my thoughts and understanding of what I read!
 
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Thank you very much for your reply, it confirms my thoughts and understanding of what I read!
You are correct that Lymphoma is a systemic disease so you have always have it. Lymphomas are coded from the C81 to C88 categories in ICD-10. I was taught to code it active based on the current or most recent site(s) of disease and to never be coded to history UNLESS the physician specifically states that the patient is completely disease-free or cured - which I've only seen twice in the 25 years I've been coding (20 years in Oncology) and both of those were in patients who had gone through treatment, were completely asymptomatic and had been free of recurrence for 15+ years.

I don't have any references currently available that I can upload but I have found the Coding Strategies Navigator for Oncology Diagnosis Coding to be extremely helpful as a reference tool in general.
is there any documentatio in the Coding Strategies Navigator for Oncology Diagnosis Coding that you can share on this issue?
 

trarut

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is there any documentatio in the Coding Strategies Navigator for Oncology Diagnosis Coding that you can share on this issue?
I can't scan the pages and will have to paraphrase:

For Lymphoma, the guidance is do not assign a code for personal history unless the physician specifically documents that the patient has no evidence of disease AND that the lymphoma is now "history of" and not active. (Rarely happens in my experience.)

For Leukemia, the Navigator explains patients with leukemia are seldom found to have no disease so it's rare to use a history code for them. And advises not to use a "history of" code for patients in Remission. Be sure to use Remission codes.

Hope that helps.
 
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I can't scan the pages and will have to paraphrase:

For Lymphoma, the guidance is do not assign a code for personal history unless the physician specifically documents that the patient has no evidence of disease AND that the lymphoma is now "history of" and not active. (Rarely happens in my experience.)

For Leukemia, the Navigator explains patients with leukemia are seldom found to have no disease so it's rare to use a history code for them. And advises not to use a "history of" code for patients in Remission. Be sure to use Remission codes.

Hope that helps.
Thank you very much!!
 
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