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Wiki Dx code ? -radiation oncology consultation

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Tonyj

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Pt came in for radiation oncology consultation for treatment to neck and supraclavicular lymphadenopathy. Pt had a history of lung Ca. Physician stated "diagnosis of stage IV nonsmall cell lung cancer who presents with progression of disease in the form of left supraclavicular and left internal jugular lymphadenopathy"

Do I code 196.0, 162.9 or 785.6, 162.9? Leaning toward the former.
 
Technically, if someone still has the lung cancer, they don't have a history of it. That's a V code.

Code the cancer the Pt is being treated for first (in this case it's the secondary sites), then code the primary site.

196.0 (secondary-this code covers the lymph nodes as a secondary cancer in both the neck & supraclavicular
162.9 (primary-lung)
 
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