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Dx cancer coding help

  1. #1
    Default Dx cancer coding help
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    Cancer codes always give me a hard time. Can anyone assist me with these diagnosis codes? I can use a code given by the path report but what about the mets? Thanks in advance. Please read below.

    Physicians Note: 10/1/10
    CT- extensive mets. Diagnosed with metastatic carcinoma most consistent with urothelial primary.
    What Dx code should I use???

    History: pt had renal cell carcinoma 1996 (removed by nephrectomy); Melanoma L arm - resected in 02/2009 (superficial spreading- 0.75 mm)

    As per cytopathology report: ICD9 Codes: 198.5
    History of melanoma and right nephrectomy for ureteral tumor.
    Now with apparent metastatic lesions.
    Bone, left ilium (CT-guided fine needle aspiration):
    Metastatic carcinoma, most consistent with urothelial
    primary (see comment).

    Cell Block Study: Metastatic carcinoma, most consistent
    with urothelial primary.


  2. Default
    for the renal cell ca the code would be V10.52 from the info given stating history not current malignancy

    the melanoma would also be a history code V10.82

    the bone mets would be 198.5 as the primary code followed by V10.52 ans V10.82

  3. #3
    Thanks for your response.
    Do I also code the urothelial primary?


  4. Default you do not code "consistent with"
    I think that you should code it this way
    198.5; V10.52; v10.82;v45.73 and v45.89

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