Results 1 to 5 of 5

How to code when 2nd is reason for TX

  1. Default How to code when 2nd is reason for TX
    Medical Coding Books
    We have a patient who has unknown primary and lung secondary.
    The doctor is treating it as if it is a lung primary.
    How should we code this for billing?

  2. #2
    Default
    You would still code the lung secondary, but list it first since that is the primary treatment, and then list the unknown primary 2nd. Hope this helps

  3. #3
    Default
    I would agree. I always code for the Mets first and then you code the primary source secondary. If primary source is unknown I would code 199.1 or you could leave blank. I have never had a problem with getting paide by insurance for just submitting a Mets dx only.
    Catrina Jacobs, RCC, CPC

  4. Default
    Quote Originally Posted by rshumate View Post
    We have a patient who has unknown primary and lung secondary.
    The doctor is treating it as if it is a lung primary.
    How should we code this for billing?
    Primary - 199.1
    2Ndary - 197.0

    Depending on what your physician's dictation, if he mentioned the unknown primary then you will have to code it with the 199.1 if nothing mentioned then 197.0 will do. I hope this help.

  5. #5
    Location
    Murfreesboro, TN
    Posts
    38
    Default
    Like the others, I agree you always list what you are treating first, even if it is a secondary neoplasm. So you code the metastatic disease with the correct code, but in the first position, then list the primary in second position. And don't forget to code any additional signs or symptoms that come into play during the course of treatment!

Similar Threads

  1. Claim adjustment reason codes -> B15 Denial Code
    By coe_angela@hotmail.com in forum Billing/Reimbursement
    Replies: 2
    Last Post: 09-14-2015, 01:57 PM
  2. Code abnormal finding or reason for exam?
    By meo59101 in forum Diagnosis Coding
    Replies: 2
    Last Post: 05-08-2014, 08:28 AM
  3. Chemo TX reason code OA121
    By tschillings in forum Hematology/Oncology
    Replies: 0
    Last Post: 04-23-2013, 02:23 PM
  4. Code result or reason for a lab?
    By AmandaW in forum Pathology & Clinical Laboratory
    Replies: 12
    Last Post: 05-11-2011, 10:11 AM
  5. Medicare Reason Code 31715
    By pattivest in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 05-05-2008, 01:05 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.