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How to code cancer when not sure if it is secondary or primary?

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PennyR

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Oelwein, IA
Good afternoon. I am coding a patient that has anal canal cancer. There is confirmed presence of cancer in the lungs "similar to the anal cancer. Likely metastatic cancer". How do I code the lung cancer? Primary or secondary? Unspecified and uncertain don't apply. I may be overthinking this, but looking for how someone else would handle this. Thank you.
 
I have no official resource for this, but in our practice, if the physician put "likely metastatic", I would code that as secondary lung. Especially if lung is a common mets of anal. You could always query your provider and ask if he/she had to select primary lung or secondary lung, which would be the code.
FYI - I only use any cancer code if it is an actual confirmed cancer, otherwise mass, or abnormal radiology, etc. Not for "likely cancer"
 
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