ICD-10-CM Specific Coding Guidelines - Neoplasms Part ONE

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now icd10 CM chapter 2 neoplasms cold SE

series c00 through

d49 how many of you had an opportunity

to watch the tap lecture I know we got a

lot of homework but how many of you had

time to view the tap

lecture go ahead type in the

chat good deal one person said hey I did

I know it's a lot two people did

somebody said I didn't it's okay it's

okay but when you have an opportunity

please you're gonna you're going to

thank yourself for it someone said they

did it was very helpful and they're so

much better at reading the guidelines in

the manual

now case and point indeed and if you're

not ready because you're kind of

overwhelmed Med by what we're already

requiring of you just take your time and

revisit it when you feel ready so just

so you know when the tap lectures are in

Vimeo they're also in your MCG manual

yes

huh I thought I had a

little I thought I did

h

oh I do I'll show you a little later but

they are in Vimeo they're in your MCG

manual and if you can't find any video

in the manual

just the logo when you click on that

logo all of the videos will populate

okay but today you should have watched

the icd10 CM tap part two

this is part two

neoplasms chapter

2 and someone said hey it did them good

now let's continue our discussion your

Paul question asked you whether or not

you knew that there

were six classifications of neoplasms

when coding and you all knew that so

let's

review have primary cancer or

malignancy this is where the cancer

origin

originates we also have secondary cancer

or

malignancy this secondary cancer

results from the primary and we call

this

metastasis or it has

metastasized also we have insitu this is

a form of malignancy but it's not always

malignant just to let you know that it

can be malignant or it may not be

malignant

but this type of malignancy is confined

to a to the S of origin without invading

the neighboring tissue so it's pretty

much

contained also we have

benign the this is not a malignancy but

these are abnormal non-cancerous

cells we also have uncertain neoplasms

that means the provider can't determine

the nature of the neoplasm so they don't

know if it's malignant or not and

finally

unspecified there's insufficient

information in the medical record to

assign a specific

code these are the meanings of these

classifications

and some I just want to kind of drive

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home a little bit about the nature or

the evolution of

cancer so in this

um this represents the prostate and I'm

going to try and show you how cancer

evolves I'm going to try

all right so the first image represents

normal cells found within the prostate

gland the

second this is where you see the normal

cells begin to grow and multiply and

these are benign cells they're not

cancerous so we're going to call them

benign but when those benign cells

continue to grow and multiply Supply and

they begin to damage other cells within

the prostate

gland and they

even these start becoming classified as

malignancy or they can be malignant or

they are okay in this

exercise and this is lowgrade

malignancy now they become High grade

when you have significant structural

damage of that gland and it's caused by

these cells becoming aggressive and look

at the mutation they've mutated into

something that could look like a

tumor right and at this stage the cancer

is aggressive and the patient is really

sick and if that isn't enough the

aggressive cancer cells begin to move

move to other parts of the body like

bone and this is what we

call secondary cancer another word for

secondary

metastasis or the cancer has

metastasized so the first two images are

benign cells um they're uncertain cells

or unspecified cells

the next two represent primary cancer or

insitu or insitu cancer and then the

last image represents secondary

cancer and I'm finished and I'mma let

that marinade hopefully it helps

understand helps you as a coder

understand how prostate or how cancer

evolves how normal cells

evolve better now let's get to

our icd1 CM let's take a look at

it and let's just observe the columns in

the

neoplasms table this neoplasms table is

in the index it's in the alphabetic

index it's after the guidelines it's

yeah it's after the guidelines right

there and these six

classifications are found at the top of

the um table so the First Column all of

the codes within the

first Cancer all of the

second secondary cancer and we also call

this cancer Mets or metastasizes

or um secondary cancer then you have

your cancer and

situ

benign

uncertain and

unspecified

behavior and when your documentation

specifies the type of cancer that's

where you get your

code now let's talk a little more about

this neoplasms

table well the first thing all cancers

are not coated from this table not all

cancers but your malignancies pretty

much are the types of cancers that are

not coated using this table or typically

your Omas your

saroma lipoma that's not necessarily a

cancer but it could be

neoplasma also adoma carcinoma

they are not from this

chart or table but where can you find

it of course you can find it in the

alphabetic

index so you may say well don't we go to

the alphabetic index first

anyway

right not for neoplasms you can go right

to the neoplasms table and then verify

in the tabular

list I'mma say it again you can go right

to the neoplasms table look up your code

then verify it in the tabular

list all right coders I'm saying a lot

and I want to know how you're doing you

doing

good

people say they're doing great okay

another thing I want to tell you about

these um columns the first three are

cancerous cancer and situ um can be

cancerous or not so we're going to put

it in the cancerous um section and the

last three are not cancerous they're not

considered cancerous

now let's go ahead and let's code

together using this neoplasms

table all