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active vs history of breast cancer

  1. Default active vs history of breast cancer
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    A colleague and I are debating whether to consider this patient as having active breast cancer. If patient will be on Herceptin indefinitely (she comes in every 3 wks) will she always be considered to have active breast cancer? Background is initial dx of breast cancer in 2003, bilateral mastectomy in 2004 (BRCA 1 and BRCA 2 mutation). Liver mets diagnosed March 2005 with ablation of liver lesion June 2005. Started Herceptin April 2005. July 2005 CT scan reveals no metastatic disease. Thanks for any input.

  2. #2
    Technically, Herceptin is hormone therapy, but it is being given because the patient has breast cancer. In my opinion, that is "actively treating" the disease. Yes, she will always have breast cancer. Now, if ICD-1o offers an in remission code, I'd consider using that in the future.

    Tracy Helget, CPC

  3. #3
    Grand Rapids, MI
    I agree Tracy. If we have a patient still being treated, we still code them with a breast cancer code. Once treatment stops, we then bill V10.3. There has been previous discussion on this thread that says that if a patient has a history of breast but it comes back as a mets then we would still bill it as history of Breast and I disagree with this. If we are going to again give chemo because the breast cancer has returned as a mets, we would use the 174.x

  4. #4
    Columbia, MO
    If it returns as a mets then you code the metastatic site and the breats cancer as hx of. If it is a recurrence at the primary site, this is not a mets it is a recurrence and it is coded as active. Herceptin is still treating active breast cancer cells so it is coded as active cancer. When the mets is no longer detected then it is no longer coder, only the primary is coded in this case as either active or hx of. The original post.. states no more evidence of mets to the liver but still on herceptin so code as active breast ca 179.4

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Quote Originally Posted by mitchellde View Post
    ... The original post.. states no more evidence of mets to the liver but still on herceptin so code as active breast ca 179.4
    I'm certain you meant active breast cancer 174.x .

  6. #6
    Columbia, MO
    Yes you are correct I am very dyslexic at times! Thanks for helping me out.

    Debra A. Mitchell, MSPH, CPC-H

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