Hematology and Oncology Coding- History codes

Marianne614

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I am a coder for a cancer center. I am trying to get some information on coding for cancer that has been excised and no longer active. I know it is a Z08 code and a history code. However, if they are on estrogen receptors is that the same???

I know there are big fines for coding for inactive cancers.

Thanks-

I would appreciate all the input you can give to me...
 

jbrandt

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Columbus, OH
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History Codes

Hi,
By "on estrogen receptors" do you mean they're taking tamoxifen or an aromatase inhibitor? If so, our physicians (and myself) consider the patient still on active treatment & would code the breast neoplasm as well as the ER/PR status. If the patient's no longer doing any sort of treatment (i.e. radiation, surgery, chemo, aromatase inhibitor) & is being seen for surveillance then I'd code it as personal history of breast neoplasm, the ER/PR status & the Z08 code. Hope this helps!
 

debrak395

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History Codes

With reference to the comment by jbrandt, it is my understanding regarding anti-estrogen drugs (SERMS, aromatase inhibitors) that if the anti-estrogen agent is being taken as adjuvant therapy by a patient with active cancer, then the cancer code is used as the primary dx, with the Z79 code as a secondary dx; but if the agent is being taken to prevent recurrence in a patient with history of cancer (cancer-free and who is not receiving treatment for a current cancer), you assign the code for personal history of malignant neoplasm in conjunction with the Z79 code. It is my understanding that the SERMS, aromatase inhibitors is not considered active treatment in a patient that is considered cancer-free but rather being taken to prevent recurrence.

Debra K, CPC
 

donn999

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Tacoma WA
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