Wiki History AND new breast cancer??

[TJLyons]

How should we code an account for the cancer treatment center when a patient has a history of left breast cancer (Z85.3) and a new diagnosis of right breast cancer (C50.411)? We are getting a Medicare edit stating: Code Z85.3 is incompatible with code C50.411.

 

[gbgentry@earthlink.net]

Different sites so we've been told it's ok to use both.

 

[kdlberg]

I can see why it doesn't want both, which is because the history code doesn't make a distinction between sites or laterality. Normally, I'd say drop the hx code if it's causing trouble. But the fact the patient has already had breast cancer is relevant to treatment options, so IMO it needs to get on claims and in the payer's records.