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Recurrent Carcinoma

  1. Default Recurrent Carcinoma
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    What is the code for Recurrent carcinoma of the right neck?

  2. Default Re:icd recurrent neoplam
    Per guideline, I'd code 198.89 as PDX if just specified as NECK (or 198.2 PDX if specified as SKIN/excision site) with added v10.89 to relect h/o primary CA(195.0).
    PS: Chapter 2 Neoplasm"d' guideline section.


  3. #3
    Columbia, MO
    I would not jump right onto a metastatic code without more information. If the neck is a new organ for the same cancer then yes it is metatatic. If it is a different site of the same organ then no it is not metastatic it is the same primary neoplasm code. What is need here is what kind of neoplasm is it, ie skin cancer, lymphoma, etc, and where was the primary site. There is just not enough information to give a good answer.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Columbia, MO
    A little additional infor :
    Recurrent cancer is when cancer returns or develops again after all visible evidence of a tumor has been eradicated through treatment. Locally recurrent recurs at the area of the original or primary tumor. Distant recurrence recurs as metastases. According to coding guidelines, recurrent primary cancer (locally recurrent) is coded as a primary malignancy of the stated site (AHA Coding Clinic for ICD-9-CM, 1985, May-June, pages 9-12). If the cancer recurs as metastases, assign a metastatic code for the specified site.

    Head and neck cancer is malignant tumors of areas in the head and neck with the exception of brain tumors. Sometimes referred to as throat cancer, it accounts for 3% to 5% of all cancers in the United States. The most common cause of head and neck cancer is the excessive use of tobacco (including smokeless tobacco) and alcohol. Other risk factors include sun exposure to lips, radiation to head and neck, nickel dust inhalation, and exposure to asbestos.
    Cancers of the head and neck are further identified by the tumor location. The following include some specific locations with the ICD-9-CM code classification in parentheses:
    • Oral cavity includes lips (140.x), front two-thirds of the tongue (141.1-141.4), gums (143.x), buccal mucosa (145.0), floor of mouth under the tongue (144.x), hard palate (145.2), and the small area behind the wisdom teeth called retromolar trigone (145.6)
    • Salivary glands (142.x) are located under the tongue (sublingual gland), in front of the ears (parotid gland), and in the floor of the mouth (submandibular gland)
    • Paranasal sinuses (160.2-160.5)
    • Nasal cavity (160.0)
    • Nasopharynx (147.x), which is the upper part of the throat behind the nose
    • Oropharynx (146.x), which is the middle part of the throat that is behind the mouth and includes the soft palate (145.3), base of tongue (141.0), and tonsils (146.0)
    • Hypopharynx (148.x) includes the lower part of the throat
    • Larynx (161.x) contains vocal cords and epiglottis
    “X” denotes that a fourth-digit subcategory is required to further classify the specified site of the malignancy.
    Code 195.0 is assigned when a primary site head and neck malignant neoplasm is diagnosed but the point of origin cannot be determined. Sometimes, cancer is found in the lymph nodes of the upper neck (196.0) when there is no evidence of cancer in other parts of the head and neck. This is called metastatic neck cancer with unseen (occult) primary.
    Most head and neck cancers are squamous cell carcinomas, which are tumors that develop in the tissues lining the hollow organs of the body.

    Debra A. Mitchell, MSPH, CPC-H

  5. Thumbs up Recurrent Cancer
    Excellent reply.
    I was looking up in ICD-9 and there is no an aswer about recurrent, unless I missed it. Anyhow, thank you very much you. You are awasome, Marisol Pineda,CPC

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