Resolved Cancer Question

[KalliP_67450]

I am watching one of the videos on coding secondary cancers from this group and have a question.


In this video, an example was given the patient comes into the office for his injection for prostate cancer. The patient also has a history of bladder cancer. From what I am gathering, you code prostate cancer as secondary because bladder cancer was primary cancer back however far it could be. My question is, if a person had cancer 10 years ago, say lung cancer. Now, after ten years the patient develops breast cancer, you can't just assume this breast cancer is secondary just because the patient had lung cancer years ago right? Don't you have to base it off what the documentation says and link it to the lung cancer in order to code it as secondary?

Thanks!

 

[Lori]

Yes documentation should always be your guide.

ICD-10-CM Official Guidelines for Coding andReporting FY 2021 Page 37 of 126

2) Encounter for treatment of secondary malignancy When an encounter is for a primary malignancy with metastasis and treatment is directed toward the metastatic (secondary) site(s) only, the metastatic site(s) is designated as the principal/first-listed diagnosis

Metastatic
×
Of or pertaining to metastasis, or the process by which malignant neoplasms can shed individual cells, which can travel through the lymph vessels or blood vessels, lodge in some distant organ, and grow into tumors in their own right. There are two major routes of metastasis 1. Hematogenous, in which cells travel through the blood vessels. 2. Lymphogenous, in which the lymphatic vessels conduct the cancer cells. In the case of lymphogenous metastasis, the metastatic tumors can grow from cancer cells entrapped in the lymph nodes that collect the lymph draining from the organ where the original cancer has developed, causing the nodes to enlarge.

The following statement was same for breast to lung:

Second Cancers After Lung Cancer​

Cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors develop a new, unrelated cancer later. This is called a second cancer.
Unfortunately, being treated for lung cancer doesn’t mean you can’t get another cancer. People who have had lung cancer can still get the same types of cancers that other people get. In fact, they might be at higher risk for certain types of cancer.

Second Cancers After Lung Cancer | Second Lung Cancer

Survivors of lung cancer are often worried about facing cancer again. Learn about the risk of second cancers after non-small cell lung cancer here.

www.cancer.org

 

[KalliP_67450]

Thank you! That's what I thought. I guess I was just thinking too far outside the box for a simple question. Lol.