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ICD-10 Ch 2 C codes
ICD-10 Neoplasms - tumors - cancer
| Question | Answer |
|---|---|
| First step in coding a neoplasm. | Read record to determine if neoplasm is benign, in-situ, malignant, or uncertain histologic behavior. |
| How should the coder code primary malignant neoplasms which are overlapping? | Classify to subcategory .8 (overlapping lesions), UNLESS the combination is indexed elsewhere. |
| How should the coder code if there are multiple neoplasms that are NOT contiguous? | A separate code should be used for each of the tumor locations. |
| How are malignant tumors of ectopic tissue coded? | Code to the site of origin mentioned in the medical record. |
| If the histologic term for a neoplasm is documented, what should be referenced first? The Alphabetic Index or the Neoplasm Table? Why? | The Alphabetic Index. To determine which column of the Table is appropriate. |
| Is it necessary to go to the Tabular after referencing the Neoplasm Table? | Yes |
| What is the principal diagnosis when the treatment is directed at the malignancy? | the malignancy UNLESS if sole reason for admission/encounter is chemo/rad tx/immunotherapy. |
| If sole reason for admission/encounter is chemo/rad tx/immunotherapy. what should be coded first? | Z51.-- is first followed by malignancy dx. |
| If encounter is solely to treat a secondary site of malignancy while the primary malignancy is still present, what is considered the principal dx/first coded? | The secondary neoplasm. |
| Are there any coding guidelines specifically for complications of malignancies and/or their treatment? | Yes, Anemia due to malignancy, due to chemo/immun tx/rad tx, dehydration, complication from surgical procedure all have their own guidelines in Chapter 2. |
| If there is no longer any evidence of the primary tumor, what code should be used? | Personal History of malignant tumor Z85. |
| If the primary tumor gone, but a secondary site has been discovered invastion, extension, or metastisis, what should be coded? | The secondary site first-listed as a secondary tumor followed by Personal Hx of previous primary tumor/site. |
| Where should the coder look for coding guidelines regarding complications of chemo/tad tx/immun tx? | In Chapter 2 guidelines. First-listed/principal code is the malignancy; followed by codes for complications. |
| If both surgery and chemo/rad tx are performed in the same encounter/admission, what should be coded first? | the neoplasm code is first. |
| Under what circumstances would the code for "Disseminated malignant neoplasm, unspecified" be used? | ONLY when widespread metastasis with no specified primary or secondary site |
| Under what circumstances would the code for "Malignant (primary) neoplasm, unspecified" be used? | When no determination can be made as to the primary site of the malignancy. |
| What code equates to "Cancer, unspecified"? | "Malignant (primary) neoplasm, unspecified" . Code C80.1 |
| Where can a coder look to determine appropriate sequencing of neoplasm codes? | Chapter 2 guidelines, L 1) - 6) |
| If a malignancy occurs in a transplanted organ, what is the correct first code? | code for a transplant complication is first; then code for Malignant neoplasm assoc with transplanted organ. |
| Steps for coding a neoplasm | 1. ID histology/morphology; 2. Refer Neoplasm Table; 3. Find correct column in Neoplasm Table; 4. Reference Tabular List. |
| Sequencing of diagnosis codes depends on type of tumor treatment is directed toward. True or False? | True. If tx is directed at primary tumor, primary tumor is first-coded. If tx is directed at secondary tumor, secondary tumor is first-listed. |
| If encounter is for only chemo/rad/immun tx, then which code is the first-listed code? | the first-listed code is a Z51- code |
| If the encounter is to treat a complication associated with a neoplasm, what is the correct sequence for coding the malignancy and its complication? | The complication is first listed; Then the malignancy is next. Exception: Anemia assoc with malignancy.0.0 |
| How many codes are needed when an encounter is to treat a side effect of tx for the malignancy? | Three. 1. code for the complication; 2. Adverse Effect code; 3. Neoplasm code. |
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