History of code for secondary cancer

[apmgreer]

Do you use a "History of" code for a secondary cancer? For example, the patient is in for a 2017 followup visit. She was diagnosed in 2005 with breast cancer. In 2007 she had metastasis to her bones. Do you code Z08, Z85.3 or do you code Z08, Z85.3, Z85.830 (history of bone cancer)?

I wondering if the neoplasm "History of" codes are used to specify the type of cancer the patient had or to specify the locations where the patient had cancer. Any thoughts?

Thanks in advance!

 

[mitchellde]

If the primary and the secondary sites are no ;longer active, you code only history of the primary site. the secondary site is still the same neoplasm as the primary site. If the primary site is no longer active however the secondary site is active then you code the secondary site and then code the primary site as history of.
for your statement:
"Do you code Z08, Z85.3 or do you code Z08, Z85.3, Z85.830 (history of bone cancer)?"
if all sites are no longer active and no further treatment ( remember tamoxifen and equivalent treatments are for active breast cancer), you would the encounter as the Z08 for the follow up and the Z85.3 for the history of breast cancer. If the breast cancer is still being managed with drugs such as tamoxifen then you would just code the C50 code for the breast cancer.