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Unspecified Nature vs uncertain behavior

  1. #1
    Smile Unspecified Nature vs uncertain behavior
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    I am in the beginning stages of becoming a certified dermatology coder and I need help determining what the difference is between 238.2 and 239.2? We have been using 238.2 quite often and I am not sure if we should really be using the 239.2 instead? Any help would be greatly appreciated.

  2. #2
    This was a topic of discussion in our office quite recently...there is a great article put out by AHIMA (one of the four organizations that makes up the cooperating parties for ICD9) that makes coding neoplasms a breeze. Here's the link:


    or...just type in "coding neoplasm uncertain behavior" in your web browser and it should bring up the article found in the AHIMA mag called "Advance for Health Professionals".

    Hope this helps!

    V Davis, CPC

  3. #3
    Thanks for the link. It'll be a great reference the next time this discussion comes up in our department as this conversation has a way of coming up every so often (usually when we have new residents starting).

    What I have been taught was that the 238.2 code should only be assigned when there has already been a biopsy done and pathology still can not determine whether the neoplasm is malignant or not and further treatment is advised. Even then we will still hold the charges from the reexcision until pathology has come back so that we may submit the most accurate diagnosis to the insurance company for claims processing.

    239.2 we generally use when we are doing a biopsy on a questionable neoplasm, but there have been no biopsies performed for a definative diagnosis.

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