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Chapter 5 Basic Code

Basic ICD-9-CM Coding 2011 CHAP 5 Author: Lou Ann Schraffenberger. AHIMA

What is the name and category #'s of chapter 2 in ICD-9-CM? Neoplasms (140-239)
What is the definition of a neoplasms? Any new or abnormal growth.
In ICD-9-CM coding, neoplasms are classified according to what 3 criteria? 1. Behavior (malignant/benign) 2. Anatomical site 3. Morphology type (ex. leukemia, melanoma, adenocarcinoma)
Neoplasms collectively referred to as cancers. It can invade and destroy adjacent structures, as well as spread to distant sites to cause death. Malignant
Neoplasm in which the tumor cells undergo malignant changes but are still confined to the point of origin w/o invasion of surrounding normal tissue. In Situ, also known as noninfiltrating, noninvasive, intraepithelial, or preinvasive carcinoma.
The Alphabetic Index to Diseases contains a table for neoplasms. It contains 7 columns. The 1st column list the neolplasm by what? While the next 6 identify what about the neoplasm. 1. Anatomical site 2-7 behavior. (primary, secondary, and carcinoma in situ)
Codes that explain the histology, behavior or characteristics of a neoplasm. They are used primarily by cancer or tumor registries in hospitals to identify the specific histology and behavior of the neoplasm. Morphology (M codes)
In morphology codes the 1st 4 digits identify what about the neoplasm and the 5th digit indicates what? 1-4 the histological type 5th digit indicates the behavior (/0 benign, /2 in situ)
When a diagnosis contains two qualifying adjectives with different morphology codes such as papillary (M8050/3) serous (M8460/3) carcinoma which code should be selected? The higher code is assigned (M8460/3)
These codes provide a method for reporting encounters for chemotherapy, radiation therapy, and follow-up visits, as well as a way to indicate a history of primary malignancy or a family history of cancer. V codes
Guidelines for V codes: If the treatment is directed at the malignancy, designate the malignancy as the principal diagnosis. The only exception to this guideline is if the patients admission is for what? Chemotherapy, immunotherapy, or radiation therapy. In this case the therapy would be the principal diagnosis followed by the malignancy.
When a patient is admitted for chemotherapy and develops a complication, such as uncontrolled nausea and vomiting what would be the primary diagnosis? V58.11 Encounter for chemotherapy. Additional codes would include the cancer followed by all complications.
This code describes a patient who is "cured" of a malignancy and is used only to indicate the former site of a primary malignancy. V10
To code neoplasms locate the morphology of the tumor in the Alphabetic Index. They are classified by system, organ or site. Exceptions to this rule are what? In these cases the index may offer direction to the neoplasm table. Neoplasms of the lymphatic and hematopoietic system Malignant melanomas of the skin lipomas common tumors of the bone, uterus, and ovary.
This is a symptom of hyperestrogenism. It is coded as excessive or frequent menstruation (626.2). Menometrorrhagia
The tubular list may advise the coder to "use additional code, if desired, to identify any functional activity." What does this mean? It means to code any functional activity associated with a particular neoplasm, such as increased or decreased hormone production due to the presence of a tumor. ex) hyperestrogenism
Variations exists with these 2 categories in which no uniform agreement exists with these terms and therefore the codes reflect the different terminology used. Malignant neoplasms of the esophagus (150) Hodgkin's disease (201)
Malignant neoplasms are separated into primary sites (140-195) and secondary or metastastatic sites (196-198). Neoplasms of these two systems are always coded to categories 200-208, regardless of whether the neoplasm is stated as primary or secondary. Lymphatic and hematopoietic systems- ex: leukemias and lymphomas.
Neuroendocrine tumors include both malignant and benign. They are classified into what two types? Carcinoid tumors and pancreatic endocrine tumors.
If the primary site of the tumor could not be determined by the physician which code should be assigned? unknown site or unspecified, 199.1
When a neoplasm is identified as a papilloma of any type, that condition should be classified as what type of neoplasm? Benign
When the neoplasm is identified as a squamous cell carcinoma or an epidermoid carcinoma, that condition should be classified at what type of neoplasm? Malignant
If the physician documents the origin of the tumor as two adjacent sites how should you classify the fourth-digit subcategory? These codes are provided to identify circumstances when the physician cannot ascertain precisely where the neoplasm originated. 8, "other"
When surgical removal of a primary site malignancy is followed by adjunct chemotherapy or radiotherapy which code is assigned. The malignancy code 140-198 or 200-208
If a previously removed neoplasm reoccurs do you code it as a primary or secondary neoplasm? Primary, unless the Alphabetic Index directs otherwise.
A malignant neoplasm of a transplanted organ should be coded as what? The primary diagnosis would be a subcategory from 996.8, complication of transpanted organ followed by 199.2, Malignant neoplasm associated with transplanted organ.
The terms "metastic to" and "direct extension to" are used to classify what? 'Secondary' malignant neoplasms
Where do myelomas originate from? Bone marrow
leukemia are classified according to their site and their stage such is acute or chronic what are there types? types of leukemia are lymphoid, myeloid and monocytic.
This code may be assigned as a principal diagnosis when the stated reason for admission is documented as neoplasm pain control or pain management. 338.3 neoplasm related pain
when a patient admitted or treated for a primary malignancy with metastisis and the treatment is directed towards the second sight only what should be coded as the princible diagnosis? secondary neoplasm
if a patient with a neoplasm suffers from a complication associated with the malignancy or the therapy provided what would be coded first? the complication such as dehydration followed by either the malignancy or by e933.1, adverse effects of antineoplastic and immunosuppressive drugs.
If a patient has a 'history' of a primary site neoplasm and develop a secondary neoplasm how would this be code? the secondary site is assigned first with a category v10 code used as an additional diagnosis
What is a difference between icd-9 & icd-10 in regards to how the the neoplasm table is located? Icd-10 the neoplasm table is a septate entry within the codebook rather than being listed alphabatically under N for neoplasm.
Neoplasm behavior in which neoplasm growth does not invade adjacent structures or spread to distant sites but may displace or exert pressure on adjacent structures. Benign
Neoplasm behavior. The site to which the neoplasm has spread. Secondary
Created by: 100000223367771
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