Wiki Recurrent versus Metastastes

[KMayercsik]

First off, I do know the difference between local recurrence and distant recurrence.
We have a patient that had treatment for supraglottic cancer, 2012, treated and eradicated.
The patient returns with a mediastinal mass, no biopsy, no pathology. The doctor is stating 'recurrent head and neck cancer of the mediastinum'. There is PET stating a mediastinal mass that is 'certainly malignant'.
Do I code mediastinal mass (R22.2) or (J98.9).
All advice is appreciated and needed!

 

[mitchellde]

If the physician statement states recurrent head and neck ca of the mediastinum. Then it is metastatic cancer with a history of a primary. So code the mediastinum as secondary (metastatic) and you head and neck cancer as history of. Sequence the secondary neoplasm first and the history of code second. I will not give you the codes, as I feel it is important that you look them up. This is the logic for which codes you need. Neither the R22.2 nor the J98.9 is correct.

 

[KMayercsik]

Thanks!

Thanks.