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Neoplasm of uncertain behavior

  1. #1
    Question Neoplasm of uncertain behavior
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    I understand that ICD-9 238.2 (Neoplasm of uncertain behavior of skin) should not be used unless the specimen has been sent to path and a firm distinction between malignant and benign can't be made.

    What code does a provider use if she/he is not removing the lesion but referring the patient to a dermatologist?

  2. Default
    Have you looked at 239.2?

  3. #3
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    I wondered about 239.2. I read that it should seldom be used but perhaps the scenario I described is one of those "seldom" times?

  4. #4
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    I would use tabular list Neoplasm, the specific area in question and uncertin behavior if you know it is a neoplasm. If it comes back benign they will use the begnin code. That is what I would do.

    DLM

  5. Default
    I was taught - a long time ago - that the only time you can use the 'uncertain behavior' diagnosis codes is when the pathology comes back stating exactly that - something with 'uncertain behavior' - you can't use it for a growth that you don't know if it's benign or malignant. This is a good question for CPT Assistant.

  6. #6
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    You use the 709.0 or 709.9 when sending the patient to a specialist. 239 code for unspecified according to the AHA is to be used after a preliminary diagnostic study reveals a diagnosis of a tumor of some sort, it is considered a "working diagnosis" it implies that a preliminary study has shown this to be neither cystic nor an abscess but a tumor which is a neoplastic process that has yet to be determined as to its morphology.

    Debra A. Mitchell, MSPH, CPC-H

  7. Default
    Quote Originally Posted by dmaguire View Post
    I would use tabular list Neoplasm, the specific area in question and uncertin behavior if you know it is a neoplasm. If it comes back benign they will use the begnin code. That is what I would do.

    DLM

    I'm sorry, but this is incorrect. Only use 'uncertain behavior' if pathology returns with uncertain morphology. I believe this is explained in the front of the ICD-9.

    Dee
    CPC, CPMA, CPCD
    Dee
    CPC, CPCO, CPMA, CPCD

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