Wiki DX question

[sdunaway1]

When is it appropriate to use a hx dx of a tumor as a prime dx code rather than the actual tumor dx that was originaly correct?

Thank you for your help!

 

[sdunaway1]

***It does state in the icd-9 book that you should use hx when a primary malignancy has been previously excised or eradicated from its site and there is no further tx directed to that site and there is no evidences of any existing primary malignancy, a code for category v10 should be used to indicate the former site of the malignancy.
I am confused on a patient that comes in for a yearly fup visit after they have completed chemo, and the tumor has been excised . Should I use the v code as the primary code?

 

[mitchellde]

Yes if this was a malignancy that has no evidence of disease and is no longer requiring treatment then you use the V code for history and it can be first listed. However I'df the patient is still receiving treatment then it is still active cance such as breast cancer where the patient is still receiving tamoxifen.

 

[sdunaway1]

Thank you for your reply, I am clear on the timing of coding out hx when the pt is all done with treatment but it gets a little tricky when the patient has a glioblastoma and we are stll monitoring them. Would this type of patient ever be considered hx of prime or should we always code out the prime cancer dx?

thank you again