Wiki Help with ICD 10 codes in Oncology dpt

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stalogeorgiou

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I `m a new coder in inpatient oncology department and i really need help for 2 cases!

1) A known patient with a Lung Ca, is admitted due to a severe dyspnoea. After examinations done , the doctor wrote the following diagnosis : pulmonary embolism
I code as a principal diagnosis `` I26.99`` followed by C34.9. Am i correct?

2) A known patient with rectal cancer, admitted due to ``acute renal failure `` due to chemio therapy. Do i code N17.9 as a principal diangnosis followed by C20.x and T45.1?

Both patients are still under chemotherapy treatment.

Additional in a scenario were a known patient with lung Ca was admitted for the treatment of ``dyspnoea`, can i code `` dyspnoea`` as a Principal diagnosis if no other cause was found for it or i must code ``` lung malignancy`` ?


Thank you in advance,

Georgiou Stalo
 
Hi Georgiou,
Both look correct to me as answers. You might want to put dx Z51.11 as last dx..just let payers know in chemotherapy. However when patient come for only chemotherapy CPT 96420-96425 96401-96417) put that dx first Z51.12 orz51.0 or Z51.11 and J code amounts of drugs given,proper CPT and type of CA, referring doc and nurse administrating it.
Here some other tips.....
Differ dx codes for malignant cancer start with letter C vs benign neoplasms D00.(not cancerous), Carcinoma in situ usually start with letter D too. The moving/growth metastatic CA dx C79-C83 or look in guide in ICD10 manual. The follow up Z dx code last is dx Z08 once CA cured. Most CA takes 5 years to be gone but depends on patient& cancer..
If provider use history of past CA hope use date or after 5 years use dx Z85 per CA body location.
Basal Cell Cancer is C44,
If patient has cancer pain add dx G89.3 but must be documented along with type of current Cancer.
If patent has cancer with Anemia use dx D63.0
If patient has lung CA or heart problems add smoking history current or past if applicable to the patient
I hope helped you.
Lady T
 
Dear Lady T thank you for your help and tips given to me....
Due to several guidelines existing for malignancy , i would also like to ask you about using codes from chapter 18 as a Primary or First listed codes in malignancy.
eg :
If a known patient with lung Ca was admitted for the treatment of ``dyspnoea`, can i code `` dyspnoea`` as a Principal diagnosis (if no other cause was found for it) or i must code ``` lung malignancy` fisrt followed by R06.00 ?

The guidelines saying that codes from chapter 18 can not use to replaced malignancy codes, but on the other hand in the above scenario, ``dyspnoea , R06.00` , is the reason for admition and the only pathology was patient treated for..:unsure:

A bit confused.... Thank you for your time and answer...


Thank you in advance,

Georgiou Stalo
 
stalogeorgiou said:
Dear Lady T thank you for your help and tips given to me....
Due to several guidelines existing for malignancy , i would also like to ask you about using codes from chapter 18 as a Primary or First listed codes in malignancy.
eg :
If a known patient with lung Ca was admitted for the treatment of ``dyspnoea`, can i code `` dyspnoea`` as a Principal diagnosis (if no other cause was found for it) or i must code ``` lung malignancy` fisrt followed by R06.00 ?

The guidelines saying that codes from chapter 18 can not use to replaced malignancy codes, but on the other hand in the above scenario, ``dyspnoea , R06.00` , is the reason for admition and the only pathology was patient treated for..:unsure:

A bit confused.... Thank you for your time and answer...


Thank you in advance,

Georgiou Stalo
Click to expand...
See the guidelines from Chapter 2, section c and also section 4. If the treatment is only for the complication, you would code the complication first, followed by the neoplasm code.
 
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