Metastatic cancer coding, Metastatic cancer coding, Un instrument eficient pentru prevenirea viermilor
So remember, I told you brain cancer those would be. Brain self alright, so they go in they buy. Obviously they take the cell the metastatic cancer coding out they pathologist looks at it and they say yes, this is White matter cells or gray matter, excuse me and and that's where it was located.
So we know that that's primary malignancy of the brain and then you can divide it up to get to a higher specificity, however. Let's say they go in and look at the the lawn. They remove the mask. They look under the microscope and the Pathologist, says HM, Those are brain cells in the lung.
So it's a secondary site so the brain cells metastasize to the lung.
How do they know? Well, it was abnormal cells that weren't meant to be there. There's indications like overlapping sites that you get on metastatic cancer coding organ. Important that you always get to the highest specificity when you're dealing with that Whitney asks, would it when would it be appropriate to code Primary malignant neoplastic unspecified. There is a call for that when you have a primary malignancy and when they want higher specificity, that means and you don't have it, You can say you don't know where the primary malignancy is so let's say they have.
Lung cancer in the past hologram just does a report and says yes, this is not this. This is this is not metastatic cancer coding tissue. This is something else and so that would be unspecified cuz they don't know where it came from right specifically. But most of the time you're gonna use Neil Plasma primary and specified is when, for example, you have a patient that comes in through the ER and they say, they have they. Well, what type of cancer he had.
Oh, I don't know what type of cancer but I do know. Had cancer, you know well, then that's a primary cancer and specified in a metastasized to the lawn. So secondary cancers are also solid tumors.
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They're not metastatic cancer coding tumors. Okay so again they leukemia is cannot be a secondary cancer. So that's something that's interesting that you may not have been aware of a lot of this information that you can find higher specificity if you look into oncology and study oncology, but keep in mind. That a lot of information can be found with studying tumor registry information, so that would be a great place if uncollected is something that you're interested in that you go and check that out.
However, the some of it's metastatic cancer coding little bit different.
Okay, so they'll use like the primary and the secondary ICD code. But they added different information on their morphology and so on and so forth with the tumor registry and if you know how to read that it would allow you to get to a higher specificity because if the provider has validated that I don't validate may not be the right word it if they have recognized that signed off on that tumor registry code, then that is a part of the documentation that you can abstract.
But you have to be able to read it and understand what it is, but it can be a part of the meat if you're risk adjustment risk doing risk adjustment or you need higher specificity for a code. In fact, I think we did previously a webinar on a look into tumor registry. Metastatic cancer coding don't metastatic metastatic cancer coding coding on medical coding sort it might still be there as well. So that's the. Main differences between a primary malignancy cancer and a secondary malignancy cancer, not a whole lot of of information.
Metastatic Tumor Coding - Primary vs. Secondary Cancer
And Metastasize just means that it moved malignant means that it wants to move. If you how do they determine that a cancer is benign or malignant the pathology report would come back. They look at the metastatic cancer coding and they know by looking at the cells the characteristics of these cells are metastatic. They are opportunistic, you see hear that term a little bit. These are cells that want to migrate and move to other locations and then if it's benign, then they look at that those cells and they say no, these cells are cells that don't want to go anywhere.
They're going to stay clumped together right here. The nine cancer can still be very problematic. It means that you know it doesn't want to go from the brain to the lungs, but if you have a benign Neal plasma in your brain, there's no room there and you know a a tiny little dime size mask that may be benign can cause a lot metastatic cancer coding problems like seizures can cause a hemorrhaging.
Can cause things like memory loss or metastatic cancer coding depending on what part of the brain that is at that's in the back of the brain, You know you could lose your vision if it's in the front of the brain, you could lose your coordination.
You know it's so again, depending where it is if it's right there in the Center of the brain next to one of those glands or something then you may have a problem with metastatic cancer coding. Alright, so there's all kinds of things that it could put pressure cause migraines. Him Ridge seizures loss of the ability to use a specific body part because the brain is the computer of the body, telling the rest of papilloma virus human body.
How to function. So you know if you were having a lot of stomach issues and they can't find anything wrong and then they scan.
I am seeing lots of metastatic cancer coding come in, so I am going to save those to the end. Let me tell you metastatic cancer coding quick before we go to the next slide sequencing sequencing is very important and we're gonna talk about that a little bit, but that isn't the primary question that came in it was coding secondary malignancies.
How do we called secondary malignancies and part of that metastatic cancer coding is sequencing, but part of it is understanding what's a primary and what's a secondary cancer? Let's look at some more. Bones are cancer likes to metastasize, and I mentioned that if cancer moves to the bones, then it's a stomach right it same way if it goes through the lymphatic system when a person has breast cancer and they do a biopsy of the Mass they'll metastatic cancer coding usually always take some of the lymph nodes in the accelerate error.
In the armpit because that's where they'll be able to see if it invaded the Lymphatic system if the cells invade the Lymphatic system, the lymphatic system is a liquid throughout the whole body.
Just like your blood like leukemia would be so if you have any type of lymphatic cancer, it's a liquid cancer like leukemia and it would be systemic throughout the whole body.
Bone marrow same thing now breast cancer likes to metastasize most breast cancers do they like to go to the bones, liver lungs, brain and skin, and it's important that one they check out those lymph nodes because that's one of the ways that it travels. It usually travels through the blood of the lymphatic system and skin skin covers some skin cancers are it's not really considered liquid, but it is kind of considered the stomach.
I think because your skin covers the whole body and melanoma is extremely invasive and likes to spread and it spreads to organs very quickly it likes to dig down.
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Go to the lymphatic system so even though you may have a small lesion or spot say you know on your arm, it it you can't see what's underneath and it likes to tunnel down and get into the bloodstream and the lymphatic system.
Breast cancer again If you go and look up you can just Google it or how whatever search and you use you metastatic cancer coding say you know liver cancer, where does liver cancer like to metastasize to where does bone cancer like the metastasize? Where does lung cancer liked to metastasize? Well, we know that breast cancer likes to metastasize to these five areas, Therefore, if you've had breast cancer a history of breast cancer, then they will.
I want you to be very very conscious of any problems that you have in these other systems. So, for example, I talk about my mother having breast cancer and here a while back she metastatic cancer coding having some pain in her extremities in her legs, and then she was having some pain and some other areas and it that could be attributed to neuropathy.
Due metastatic cancer coding the chemo and stuff that she had, but they checked her brain, they wanted to make sure that none of the cells have gone to her brain.
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Same thing happened when she had kind of a persistent cough that last a little longer than it should have And she metastatic cancer coding thinking it was allergies, but again, they wanna be very cautious to make sure that even though she had breast cancer and now they would say she's a history of breast cancer.
You don't know that it doesn't come back to one of these areas. Now, everything worked out fine. She was absolutely fine, but she'll continue to always check these areas because they know they know that's where it likes to metastasize. Oh okay. Because breast cancer would be the primary and then secondary it metastasized to the long so the secondary cancer metastatic cancer coding lung cancer even though the person is a history of breast cancer, it's not active anymore, but it metastasized to the long.
It's still the lung cancer is coded as a secondary lung cancer, even though it's the only cancer being treated and maybe. As the principal diagnosis, so don't get em confused, but the code itself would not be a primary cancer code.
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metastatic cancer coding Now, let's talk about a few other words or verbiage cele mai eficiente medicamente pentru viermi really essential for you to understand when we deal with cancer history of if the patient again, we gave the example just a minute ago about breast cancer that metastasized to the lawn.
Me the halfway through treatment and the massacre tissue revealed there was no cancer cells. I therefore when treatment was done, they went through the chemo and everything they were a history of breast cancer at that point.
Okay, no more cancer detected at that time. Now, we're gonna talk about being in remission and and stuff like that, but just know a history of from a coder stand. Means that that cancer there's no evidence of the disease at that point, and it's either been eradicated or you've completely cured the cancer at that site. Okay now. If it comes back, it's still if it if it comes back at that site, it's no longer a history of okay and you can still have primary cancer come back to the same site.
They have their mammogram and they metastatic cancer coding cancer coding evidence of cancer that came back, It's no longer a history of, but it's still the primary breast cancer right because there's no evidence of disease and it's gotta be at that site.
Nothing there. Now, if you have a history of in the documentation, a lot of times, you'll notice that in the corner, they'll say you know history of and they'll say breast cancer and then you'll see the patient is currently getting radiation treatment.
Well, that's not a history of if they're primary cancer was breast cancer and they're getting radiation on the breast. But they're seeing their PCP or they're seeing a cardiologist that doesn't deal with the treatments of the cancer per say, and so they just notated up there.
Oh, by the way the patient has a history of breast cancer. Now the patient actively has breast cancer is being treated but in documentation often the providers think of history of as oh by the way, this is the list of things that they have and have had right but coders. Look at it that way our guidelines tell us that if it States a history of then, it means there's no evidence of disease and it's been eradicated.
There's been a complete cure at that site. So you don't get a history of type one diabetes because you don't cure type one metastatic cancer coding right. So if you see that a patient has a history of breast cancer, type one diabetes and let's see a BKA. Well, those are three things the history of breast cancer. Yeah, that could be a metastatic cancer coding of if they're not getting treatment anymore, but they don't have a below the knee amputation hpv virus and vaccines grow back and One diabetes doesn't go away, so it's not a list of what's actively present for that patient.
It will be a personal history of which is a zero eight five code, The secondary can still be a principled diagnosis so. If a patient is being seen for lung cancer and they have a history of breast cancer than the secondary cancer is coded first and the history eight five code will be coded second or at the end wherever it needs to be compared to what other is being coded.
That patient, but usually a history of this zip codes tend to be at the back. Also, you can have Let's see our first list diagnosed with I don't think I meant to say, see I think I meant to say to see eight five. I'm gonna have to look at that. We may have to change that guys. Now we understand history of means no evidence.
Those codes are very similar. They are zip codes. Also, there's like zero eight zero. I think with family history so metastatic cancer coding history of means no evidence of the disease.
Therefore, a better knowledge of the specific molecular mechanisms that underlie the development and progression of bladder cancer is demanded. Tumor heterogeneity among patients with similar diagnosis, as well as intratumor heterogeneity, generates difficulties in terms of targeted therapy.
There's no active treatment going on. Now, I know some of you are saying, oh, no why what about democracy? Democracy is a medication that is given to breast cancer patients. Shown to help prevent a recurrence and some people would say well, that's active treatment and other people would say no, it's not active treatment because the patient doesn't have metastatic cancer coding so Indiana the documentation it's very important that you have to query the provider is this a profiler active use of tamoxifen, meaning the patients a history of breast cancer and that they're gonna take this for five years Or is it active True?
And it's really easy to query the provider and and know whether it is because if they're taking to moxy and it's considered by that provider as active, not profiles acting just making sure it doesn't come back, then that will change the coats. Metastatic cancer coding are no longer a eight five for breast cancer history of their actively using the tomato fun as treatment and then that would be your primary or your secondary code, depending on what type of cancer it was okay.
I have some examples for you, but I think I missed a slide. Let me just go back metastatic cancer coding look real quick because this is a really cool slide. I was just telling Boyd about the slide.
Metastatic cancer coding
Yeah, I did it jumped. That's seven. Let's go back. I want you to see this slide because it's a very good example of metastasis. Let's see if it will jump to that. There we go. This is an a pet scan, a real pet scan now if you don't know what a pet scan is, it is a positron emission.
That's what detoxifiant herbagetica call it, CTP scan and it allows you to see answer throughout the body So this particular image was a 30 - metastatic cancer coding -year-old with several Tumors that metastasize from the primary breast cancer now isn't that interesting We metastatic cancer coding said all the different places that of breast cancer like to go right.
They put the the IV in. And shoot it with these ions and glucose glucose water. Well it just so happens that glucose likes to go straight to the cancer cells because and pull there because cancer cells feed off the sugar and that's the way the the nuclear medicine Guy explained that to me when we were talking to him about my son, having a pet scan done for epilepsy and it also likes to put.