Wiki malignant pleural effusion vs plerual effusion NOS

[hsschaper]

Hi, out office is debating on when to bill a malignant plerual effusion. The report says a pt has cancer. The report also states the pt has plerual effusion. It does not reference it to the cancer. One coder wants to bill the effusion as malignant because the pt has cancer. Others don't agree because it doesn't say malignant effusion. Can anyone advise us on the correct effusion code. Thanks so much.

 

[krithika]

hi,

it should be coded as pleural effusion. To bill malignant pleural effusion, it should be documented as malignant. Please see the description.

A pleural effusion is a buildup of extra fluid in the space between the lungs and the chest wall. This area is called the pleural space. About half of people with cancer develop a pleural effusion.

When cancer grows in the pleural space, it causes a malignant pleural effusion. or the fluid contains cancer cells.