using v codes for history

coder in mo

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I'm trying to see how everyone else is coding their history of cancer codes, I use the 1 year out from any treatment, surgery, drugs w/no evidence of recurrent disease, someone else has told me it's 5 years out. Just trying to get some other opinions on this. Thanks
 

Bemcg1957

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I code according to the doctors report. If he classifies it as a 56 year old with breast cancer I code it 1749, if he classifies it as a 56 year old with a history of breast cancer I code it V103. It is not up to me to determine the length of history if it is not recorded in the report.
 

coder in mo

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True, but some dr.'s here say hx of but they are still on treatment or a drug & I thought that if they are still being treated, even though dr. says hx we have to code it to the cancer code, not hx
 

Lisa Bledsoe

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ICD-9-CM coding guidelines state "When a primary malignancy has been previously excised or eradicated from its site and there is no further treatment directed to that site and there is no evidence of any existing primary malignancy, a code from category V10, Personal history of malignant neoplasm, should be used to indicate the former site of the malignancy..." I take this to mean that if the malignancy is no longer being treated because it is believed to have been "eradicated", then you should code the V code. I used to think there was a 5 year rule...not sure where that came from. If a patient is still undergoing any kind of cancer treatment however, it would not be a V code.
 

janetmoh

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What about if they are on tamoxifen for Breast Ca (usually tx for 5 yrs)? I guess you would still have to code current code not V.
 

kemptar

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Chemotherapy induced

What about a patient that has chemotherapy induced myelodysplastic syndrome? They are currently cancer free and are no longer receiving treatment for the cancer but they are still coming in for their darpo shot for the syndrome.
For this you are directed to 289.83 but you are to code the underlying condition first (174.0-174.9). Should I use the "history of" code first as the are no longer receiving treatment for the cancer? Advice is appreciated!
 
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