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Quiescent Prostate CA

  1. #1
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    Default Quiescent Prostate CA
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    If the provider documents the following...."History of prostate cancer that is quiescent," how do you code this?

    Would you report this as an active condition and use code 185 (prostate CA), or would you code this with code V10.46 (hx of prostate ca) since the provider uses the terminology of "history of?"

    I should mention here that there is no mention in the documentation that the patient is currently be treated for the prostate cancer.

    Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  2. #2
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    I would code for the prostate ca 185 because they have to been clear of ca for at least 5years for it to be consider history.
    Catrina Jacobs, RCC, CPC

  3. #3
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    Catrina,

    Where would I find documentation of this 5 year rule?
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  4. #4
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    Stuart, Florida
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    Quote Originally Posted by dballard2004 View Post
    If the provider documents the following...."History of prostate cancer that is quiescent," how do you code this?

    Would you report this as an active condition and use code 185 (prostate CA), or would you code this with code V10.46 (hx of prostate ca) since the provider uses the terminology of "history of?"

    I should mention here that there is no mention in the documentation that the patient is currently be treated for the prostate cancer.

    Thanks.
    Quiescent basically means inactive, and in this context, aka in remission. Therefore, the dx is "history of prostate cancer, in remission" and should be coded as V10.46.

    As for the 5 year rule, it should prove fairly difficult to find documentation of this rule, as it does not exist. To find the real rule for coding cancers, refer to your coding guidelines which states, "When a primary malignancy has been previously excised or eradicated from its site and there is no further treatment directed to that site and there is no evidence of any existing primary malignancy, a code from category V10, Personal history of malignant neoplasm, should be used to indicate the former site of the malignancy." Direct quote from the guidelines. You can find this info in Chapter 2: Neoplasms section d of the chapter-specific coding guidelines.

    Hope this helps!
    Vanessa Mier, CPC

  5. #5
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    Thanks so much Vanessa!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  6. #6
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    I totally agree with Vanessa

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