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Wiki Inpatient coding for suspicious carcinoma

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katiejeanne

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Hello all.
I am new to coding inpatient visits (and am the only inpatient coder at my facility) so hopefully someone will be able to guide me in the right direction...On a discharge summary for one of our Acute patients one of the diagnoses are "renal mass suspicious for renal cell carcinoma". I know that with inpatient we are to code "suspicious, questionable, probably, etc." but I want to make sure this holds true for something as serious as cancer or if there are exceptions to this rule. Can someone help? I would greatly appreciate it, thank you!!!

Katie
 
I would never code something as cancer unless I had a pathology report in my hand that states that it is cancer.
You can safely code the renal mass (593.9) though as that is verifiable.
 
You're very welcome! :D
I guess because I am an outpatient coder I insist on everything being verified as fact before I code it ;)
 
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