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Radiology Coding Alert

Reader Question:

174.x Is Just the Start for This Case

Question: How should we code malignant breast cancer with metastasis to liver and bone?Tennessee SubscriberAnswer: Report the breast cancer first using a primary malignant neoplasm code. You also should report secondary neoplasm codes for liver and bone findings.Breast: The report should identify the location of the tumor to allow you to use the most specific diagnosis code for that site, such as 174.1 (Malignant neoplasm of central portion of female breast). If documentation doesn't show the specific location, the correct code for the breast cancer is 174.9 (Malignant neoplasm of breast [female] unspecified site). Under ICD-10-CM, the code will vary based on the breast involved (for example, C50.111, Malignant neoplasm of central portion of right female breast)Metastatic sites: You also should code the metastatic cancer noted in the report. You mentioned liver, which you should report as 197.7 (Malignant neoplasm of liver secondary). For the bone metastasis, report 198.5 (Secondary [...]

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