question

A primary malignant neoplasm that overlaps 2 or more contiguous (next to each other) sites should be classified to ___.

answer

Subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere

question

How You Would Code for Multiple Neoplasms of the Same Site That Are Not Contiguous Such As Tumors in Different Quadrants of the Same Breast

answer

Codes for each site should be assigned

question

Coding Malignant Neoplasm of Ectopic Tissue

answer

Coded to the site of origin mentioned (eg ectopic pancreatic malignant neoplasms involving the stomach are coded to pancreas, unspecified).

question

Treatment directed at the malignancy

answer

Malignancy as PPDX unless patient admission/encounter is solely for the administration of chemotherapy, immunotherapy or radiation therapy, then Z51.- would be PPDX and the diagnosis or problem for which the service is being performed as a secondary diagnosis

question

When a patient is admitted because of a primary neoplasm with metastasis and treatment is directed towards the secondary site only

answer

Secondary neoplasm is PPDX even though primary is still present

question

When admission/encounter is for management of an anemia associated with the malignancy and the treatment is only for anemia

answer

Malignancy is PPDX followed by the code for the anemia (there's one that is due to neoplastic disease, D63)

question

When the admission/encounter is for management of an anemia associated with an adverse effect of the administration of chemotherapy or immunotherapy and the treatment is for the anemia

answer

Anemia code is sequenced first followed by the appropriate codes for the neoplasm and the adverse effect of the drugs

question

When the admission/encounter is for management of an anemia associated with an adverse effect of radiotherapy

answer

Anemia code is sequenced first followed by the neoplasm code and then Y84.2, Radiological procedure and radiotherapy as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure

question

When the admission/encounter is for management of dehydration due to the malignancy and only the dehydration is being treated (IV)

answer

Dehydration is sequenced first, followed by the code(s) for the malignancy

question

When the admission/encounter is for treatment of a complication resulting from a surgical procedure and treatment is directed at resolving the complication

answer

Complication is PPDX or first-listed diagnosis

question

When a primary malignancy has been previously excised or eradicated from its site and there is no further treatment directed at that site and also no evidence of any existing primary malignancy

answer

Code from category Z85, personal history of malignant neoplasm Any mention of extension, invasion, or metastasis to another site is coded as a secondary malignant neoplasm to that site. The secondary site may be the PPDX/first-listed with the Z85 code used as a secondary code

question

When an episode of care involves the surgical removal of a neoplasm, primary or secondary site, followed by adjunct chemotherapy or radiation treatment during the same episode of care

answer

Neoplasm code is PPDX/first-listed

question

If admission/encounter is solely for the administration of chemotherapy, immunotherapy or radiation therapy

answer

Assign Z51.0, Encounter for antineoplastic radiation therapy, or Z51.11, Encounter for antineoplastic chemotherapy, or Z51.12, Encounter for antineoplastic immunotherapy as the first-listed/PPDX. Secondary would be the malignancy.

question

If admission/encounter is solely for the administration of chemotherapy, immunotherapy or radiation therapy and the patient receives more than one of these therapies

answer

More than one of Z51.0, Z51.11, Z51.12 may be assigned in any sequence. Secondary would be the malignancy.

question

When a patient is admitted for the purpose of radiotherapy, immunotherapy, or chemotherapy and develops complications such as uncontrolled nausea and vomiting or dehydration

answer

PPDX is Z code for Encounter for type of antineoplastic therapy followed by any codes for the complications

question

When the reason for admission/encounter is to determine the extent of the malignancy, or for a procedure such as paracentesis or thoracentesis

answer

Primary malignancy or appropriate metastatic site is designated as the PPDX/first-listed, even though chemo or radiotherapy is administered

question

Symptoms, signs, and abnormal findings associated with an existing primary or secondary site malignancy

answer

Cannot be used to replace the malignancy as PPDX/first-listed, regardless of the number of admissions or encounter for treatment and care of the neoplasm

question

Uses of Code C80.0, Disseminated malignant neoplasm, unspecified

answer

Only in cases where the patient has advanced metastatic disease and no known primary or secondary sites are specified. Should NOT be used in place of assigning codes for the primary site and all known secondary sites

question

Uses of Code C80.1, Malignant (primary) neoplasm, unspecified

answer

Cancer, unspecified Used when no determination can be made as to the primary site of a malignancy Rarely used in the inpatient setting

question

Reason for the encounter is for treatment of a primary malignancy

answer

PPDX/First-listed is the malignancy Primary site is sequenced first, followed by any metastatic sites

question

Encounter is for a primary malignancy with metastasis and treatment is directed toward the metastatic (secondary) site(s) only

answer

PPDX/first-listed is the metastatic site(s) Primary malignancy is secondary code

question

When a pregnant woman has a malignant neoplasm

answer

Code from subcategory O9A.1-, Malignant neoplasm complicating pregnancy, childbirth, and the puerperium should be sequenced first, followed by the type of neoplasm

question

When an encounter is for management of a complication associated with a neoplasm, such as dehydration, and the treatment is only for the complication

answer

Complication coded first followed by the appropriate code(s) for the neoplasm except in cases for anemia where the malignancy is coded first

question

When an encounter is for treatment of a complication resulting from a surgical procedure performed for the treatment of the neoplasm

answer

Complication is PPDX/first-listed

question

When an encounter is for a pathological fracture due to a neoplasm and the focus of treatment is the fracture

answer

Code from M84.5, Pathological fracture in neoplastic disease, should be sequenced first, followed by the code for the neoplasm

question

Focus of treatment for neoplasm with an associated pathological fracture

answer

Neoplasm is sequenced first followed by M84.5

question

When a primary malignancy has been excised but further treatment, such as an additional surgery for the malignancy, radiation therapy or chemotherapy is directed to that site

answer

Primary malignancy code should be used until treatment is completed

question

When a primary malignancy has been previously excised or eradicated from its site, there is no further treatment (of the malignancy) directed to that site, and there is no evidence of any existing primary malignancy

answer

Code from Z85, Personal history of malignant neoplasm, should be used to indicate the former site of the malignancy

question

Leukemia Codes

answer

-Has achieved remission? -Personal history codes

question

A malignant neoplasm of a transplanted organ should be coded as ___.

answer

A transplant complication

question

Coding Malignant neoplasm associated with transplanted organ

answer

PPDX is complication code T86.-, Complications of transplanted organs and tissue, followed by code C80.2, Malignant neoplasm associated with transplanted organ. Use additional code for the specific malignancy

RHIT – ICD-10-CM – Chapter 2 Guidelines – Neoplasms – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards