Wiki Coding Secondary Cancer

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KaitlynEFitch

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When I am coding Renal Cell Cancer that spread to the Skin, I am using 198.0. But it has spread to multiple areas on the skin... and I don't want insurance to deny it if I keep using 198.0.

Do I code it only as secondary RCC? is there any way for me to code for where the primary cancer spread to ?
 
ok so first we need to know if the primary malignancy was excised.
if the primary was excised or eradicated and there is no further treatment to that site and no evidence of any existing malignant code with v10.x. "history of" but if any extension, invasion, metastasis to another site code it as secondary neoplasm to that site. or the secondary site may be the primary with a v code for secondary. hope this helps...
 
The codes for metastatic cancer are your codes for when the cancer "spreads". Always code the primary site as well as either active or history of.
 
My question is...
Do I code the Renal (KIDNEY) cell carcinoma spread to the skin as
198 secondary RCC? or do I say 198 Secondary RCC, and then 189 Primary RCC.
I think the 189 Primary RCC is sort of obvious when I say that it is "secondary RCC", meaning they clearly have primary RCC unless I put a history code.

I dislike that when coding as 198 secondary RCC, the insurance company won't know WHERE the RCC spread to.
 
No you code primary renal cell if it is still active and being treated or history of if it is no evidence of disease at the primary site. You code secondary skin since that is where the renal cell metasticised to.
so if the renal cell is still active in the primary site you will have 189 and metastatic to the skin 198.2 you sequence first the one currently being treated. if the renal cell is no longer present at the primary site and no longer being treated then code the 198.2 and the V10.52.
 
The primary dx is dependent on which site is being treated on that visit. If both are treated equally, either may be sequenced as pcx but if the primary RCC is now history of, then the metastatic site should be the PDX.
 
I thought that when coding a secondary, the decimal behind the 198._ refers to where the type of cancer cell, which I thought to be "kidney" 198.0. But instead, I code the active or history of code for the primary and then the secondary and which site it spread to?
 
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