There is an AHA coding clinic regarding this and I believe it is the M-J 1985 one. If you have a vague state like metastatic colon ca. Then if this is more common as a primary site then you code it as primary with unknown secondary (199.1). If this is a site that more common as a secondary site (like bone) the you code a metastatic ca with unknown primary (199.1). Colon ca is more common as a primary so use the code for primary colon ca with unknown secondary(199.1).
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