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Coding / Medical Billing

doesn't need to be stated metastatic? - levette

Posted: Dec 20th, 2018 - 11:27 am In Reply to: AHA Coding Handbook - former Andrews student/grad

To clarify then:

The diagnostic statements "brain carcinoma" and "metastatic brain carcinoma" code to the same code, C79.31? This is what I'm told, that's what CMS states, and it's based off the AHA Coding Handbook guidance: "Malignant neoplasms of these sites are classified as secondary when not otherwise specified."

Whereas the Coding Clinic states:
"Assign the site qualified as 'metastatic' to the primary malignant code for that stated site...except for the following sites, which should be coded as secondary neoplasm of the stated site:"

The statement from the Coding Clinic "qualified as metastatic" hung me up.

Then there's a Coding Clinic from 1994 that coded "brain carcinoma" using the Primary code without it being specified as Primary. There is a contradiction in guidelines.

And of course the site "liver" has its own special code.

I've written to the adviser but I don't know how long it will take to get an answer.

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