Coding of unknown primary neoplasm site

mrkianzky

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Hi! Need a quick answer before my class tomorrow. In the below case, would you still code an unknown primary site?

Metastasis to Zuckerkandl's organ.

The answer in the text book provided for the unknown primary site, despite having no mention of the primary site.

Can you help me come up with better rationale? Thanks.
 

mitchellde

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Yes I would still code the unknown primary. Several years ago Coding Clinics stated that you never code the metastatic site without a primary also. If not stated or know you use unknown primary. Either may be first listed depending on which is being currently treated or investigated.
Also the metastatic site is merely an extension of the primary neoplasm it is not a new cancer, just the same one that has advanced to a new location. This is why you always indicate the primary site. And again unknown when not documented.
 
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mrkianzky

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Yes I would still code the unknown primary. Several years ago Coding Clinics stated that you never code the metastatic site without a primary also. If not stated or know you use unknown primary. Either may be first listed depending on which is being currently treated or investigated.
Also the metastatic site is merely an extension of the primary neoplasm it is not a new cancer, just the same one that has advanced to a new location. This is why you always indicate the primary site. And again unknown when not documented.
Thanks Debra!

Actually, I have the same rationale in mind, because its the way we code it in my previous facility. I was just playing devil's advocate with myself, what if this is purely on a per facility basis. But for academic purposes, I'm looking into how I could best explain it to my students. I'm trying to look for a coding clinic article, unfortunately I cant seem to find one. Very helpful! Thanks!
 
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