Follicular Lymphoma with bone mets

[JM.Geyer]

Please help me understand what I was just told by a fellow coder.

I was told we can not use the code 198.5 with any 200 series code. I can't remember ever being told this in school nor can I find it anywhere I look stating that.

 

[mitchellde]

what I was told by the oncologists is that lymphoma is not like other neoplasms in that it does not metasize, so if your physician says the patient has lymphoma with bone mets we were told that there must be a primary site unknown for the bone mets and the patient also has lymphoma. My 2 cents here..

 

[melaniecpc]

bone mets from lymphoma

I would think this would be lymphoma, extranodal and solid organ sites. So a fifth digit of 0 would be used to show an extranodal site.

 

[whaleheadking]

I agree with Melanie above

 

[cosita]

It's from coding clinic april, 1992

Lymphomas are systemic diseases that do not "metastasize" in the same way that solid tumors do (classified to categories 140--199). A lymphoma, regardless of the number of sites involved, is not considered metastatic, and should be coded to the 200--202 categories. Solid tumors frequently metastasize to the lymph nodes and/or bone marrow. These are not lymphomas; they are secondary sites of the solid tumor. In cases of solid tumor metastases to the lymphatic system, a code from category 196, Secondary and unspecified malignant neoplasm of lymph nodes; code 197.8, Secondary and unspecified malignant neoplasm of spleen; or code 198.5, Secondary and unspecified malignant neoplasm of bone marrow, should be used. Lymphomas are specifically excluded from these categories. Codes 197.8 and 198.5 and codes from category 196 should never be used for lymphomas.