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Thread: Cancer coding

  1. #1
    Join Date
    Apr 2007

    Default Cancer coding

    AAPC: Back to School
    I cut and pasted this portion of the note.

    Path: Brain biopsy now showed metastatic adenoCA from lung.

    CT guided lung biopsy showed necrotic materials


    # Newly dx metastatic adenoCA with brian metastasis. the patient brian biopsy initially showed Glioblastoma multiforme but additional staining showed metastatic ADENOCA from lung. Lung CT guided biopsy showed necrotic material only.

    My question;

    How do you code for brain metatstatic adeno Ca from the lung.

    Do I code it as secondary or primary

    The confusion comes because the lung is not cancerous.

    So is the Brain coded as secondary and then just code the lung with 513.0 for the necrotic material shown on the biopsy.

    Thank You

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    If he states adenocarcinoma from the Lung and there is no current evidence of lung CA then I would assume that it is hx of so code the brain mets as your primary dx code and use a v10.x for hx of lung CA.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007


    Thank You.

  4. #4
    Join Date
    Apr 2007
    San Juan

    Default Cancer coding

    I will use code 198.3 for the metastasis. According to ICD-9-CM coding guidelines chapter 2 section: “any mention of extension, invasion, or metastasis to another site is coded as a secondary malignant neoplasm”. Therefore, the correct coding would be 198.3, 513.0, V10.11

    Gabriel Rafael Aponte, MBA, RN, CPC, COC, CIC, CRC, CPMA, CCC, CHONC, CCS, CCS-P, CDIP

  5. #5

    Default adenocarcinoma

    It appears that the scenario to be more simple. As they have confirmed the existence of adenocarcinoma of lung, we should opt for 162.9 and 198.3. Because, adenocarcinoma always lead to malignant condition always. Is it not?

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