tci Part B Insider - 2014 Issue 33

Reader Question: Avoid Malignancy Codes When Not Accurate

Question: Our physician is treating a patient for lung cancer. The patient has no brain malignancy and was administered prophylactic treatment for the brain. This was previously reported as brain cancer. Is this correct? What are the correct codes for the brain treatment when the patient actually is receiving only prophylactic therapy? Answer: It is incorrect to report the brain malignancy in this situation. The brain cancer potential as a secondary malignancy to lung cancer cannot be reported as an assumption. In diagnosis coding issues like this, you should report diagnosis code 162.X (Malignant neoplasm of trachea bronchus...

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