ICD-10-CM Specific Coding Guidelines - Neoplasms

AMCI Medical Coding

21 Dec 202324:27

EducationalLearning

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TLDRThis transcript discusses the classification and coding of neoplasms using ICD-10 CM chapter 2. The speaker reviews the six classifications of neoplasms, explains the evolution of cancer from normal to malignant cells, and provides examples of coding for primary and secondary cancers. The importance of understanding the guidelines for sequencing codes, especially for metastatic cancers, is emphasized to ensure accurate coding that reflects the patient's treatment focus.

Takeaways

📚 The ICD-10-CM Chapter 2 covers neoplasms, specifically within the codes series C00 through D49.
🎵 Background music and interactive elements are used to engage the audience throughout the lecture.
📗 TAP lectures and videos are available in Vimeo and the MCG manual, providing additional learning resources.
📌 Six classifications of neoplasms are highlighted: primary cancer, secondary cancer (metastasis), in situ, benign, uncertain, and unspecified.
📝 Primary cancer originates in a specific location, while secondary cancer results from the spread of the primary cancer.
🚨 In situ neoplasms are confined to the site of origin without invading neighboring tissues, which might be malignant or non-malignant.
💡 Uncertain neoplasms are those where the provider cannot determine the nature, and unspecified neoplasms lack sufficient information for a specific code.
🚀 An example is provided to illustrate the evolution of cancer cells from normal through benign and malignant stages, including metastasis.
🖥 The neoplasms table in the ICD-10-CM index helps in identifying the correct codes based on the classification of the neoplasm.
👨‍💻 Not all cancers are coded from the neoplasms table; certain types like saromas and carcinomas are found in the alphabetic index.

Q & A

What are the six classifications of neoplasms mentioned in the transcript?
-The six classifications of neoplasms are primary cancer/malignancy, secondary cancer/malignancy (metastasis), in situ, benign, uncertain neoplasms, and unspecified.
What is the significance of the term 'in situ' in cancer classification?
-In situ refers to a form of malignancy that is confined to the site of origin without invading the neighboring tissue, meaning it is contained and has not spread.
How does the transcript describe the evolution of cancer from normal cells?
-The transcript describes the evolution of cancer as a process where normal cells begin to grow and multiply abnormally, potentially becoming benign or malignant. Malignant cells can further evolve into high-grade malignancy, causing significant structural damage and eventually leading to secondary cancer or metastasis.
What is the default assumption when coding for prostate cancer in the absence of information specifying it as secondary?
-In the absence of information specifying it as secondary, prostate cancer defaults to being considered primary when coding.
How are neoplasms arranged in the ICD-10 CM neoplasms table?
-Neoplasms in the ICD-10 CM neoplasms table are arranged alphabetically within the first column for primary cancers, and the classifications are found at the top of the table.
What is the correct sequence for coding primary and secondary cancers when both are present, according to the transcript?
-The correct sequence for coding is to list the secondary (metastasis) cancer first, followed by the primary cancer, based on the treatment focus.
How does the transcript guide coders in verifying the correct ICD-10 CM code?
-Coders are instructed to look up the code in the neoplasms table, then verify it in the tabular list by checking for additional codes or specific instructions related to the diagnosis.
What is the ICD-10 CM code for malignant neoplasm of the prostate gland?
-The ICD-10 CM code for malignant neoplasm of the prostate gland is C61.
What are the steps a coder should take to code for a patient with primary cancer of the left bronchus and metastasis to the hip bone?
-The coder should look up each cancer separately, starting with the primary cancer of the left bronchus (C34.92) and then the metastasis to the hip bone (C79.51), following the treatment focus on the secondary cancer.
How can one access the TAP lectures mentioned in the transcript?
-The TAP lectures can be accessed through Vimeo and are also available in the MCG manual. Clicking on the logo in the manual will populate all the videos.
What guideline should be followed when coding for neoplasms to ensure success?
-When coding for neoplasms, always consider coding for what is being treated or the reason for the encounter (RF), following the specific guidelines outlined in the ICD-10 CM chapter 2.

Outlines

00:00

🎓 Introduction to ICD-10 CM Chapter 2 Neoplasms

This paragraph introduces the discussion on ICD-10 CM Chapter 2, which focuses on neoplasms. It mentions a previous lecture and encourages viewers to watch it for better understanding. The speaker addresses the audience, asking about their exposure to the TAP lecture and highlighting its usefulness. The paragraph sets the stage for a deeper dive into the classifications of neoplasms, including primary and secondary cancers, and their coding implications.

05:00

📚 Understanding Neoplasm Classifications

This section delves into the six classifications of neoplasms crucial for coding: primary malignancy (origin of cancer), secondary malignancy (resulting from primary cancer or metastasis), in situ (confined malignancy without invasion), benign (non-cancerous abnormal cells), uncertain (indeterminate nature by the provider), and unspecified (insufficient medical record information). The speaker uses the analogy of prostate cancer evolution to illustrate the nature and progression of cancer, from normal cells to metastatic disease.

10:02

🔍 ICD-10 CM Neoplasms Table Navigation

The speaker guides the audience on how to navigate the ICD-10 CM Neoplasms table, emphasizing its location in the manual and how to use it for coding malignancies. It clarifies which types of cancers are coded using this table and how to find codes for non-malignancies in the alphabetic index. The paragraph also discusses the arrangement of neoplasms in the table and the default coding for primary cancer in the absence of secondary cancer mention.

15:02

🩺 Coding Scenarios for Neoplasms

This segment presents a practical coding scenario involving a patient with prostate cancer, guiding the audience on how to find the correct ICD-10 CM code. It explains the process of looking up the code in the first column for primary cancer and verifying it in the tabular list. The speaker also addresses the need for additional codes to identify specific characteristics like hormone sensitivity status and Rising PSA following treatment. Another scenario involves coding for a patient with primary cancer of the left bronchus and metastasis to the hip bone, highlighting the importance of sequencing codes based on the treatment focus.

20:03

📝 Applying Neoplasm Coding Guidelines

The final paragraph discusses the importance of following coding guidelines for neoplasms, especially in determining the sequence of coding when dealing with multiple cancers. It emphasizes the guideline to sequence the secondary (metastasized) cancer first if that is the focus of treatment. The speaker encourages the audience to follow along in their MCG manual for a deeper understanding of the guidelines and to apply them effectively in coding practice.

Mindmap

Keywords

💡Neoplasms

Neoplasms refer to new and abnormal growths from the cells in the body, which can be either benign (non-cancerous) or malignant (cancerous). In the video, the focus is on understanding the different classifications of neoplasms, such as primary malignancies, secondary cancers (metastases), and in situ cancers, and how to code them using ICD-10 CM chapter 2 guidelines.

💡ICD-10 CM

ICD-10 CM is the United States' adaptation of the World Health Organization's International Classification of Diseases, 10th Revision, Clinical Modification. It is a standardized coding system used for reporting medical diagnoses and procedures. The video emphasizes the importance of understanding ICD-10 CM chapter 2, which is dedicated to coding neoplasms.

💡Primary Cancer

Primary cancer, also known as a primary malignancy, is a type of cancer that originates in a specific organ or part of the body. It is distinct from secondary or metastatic cancer, which has spread from its original site. In the context of the video, primary cancer is the first type of neoplasm to be considered when coding.

💡Secondary Cancer

Secondary cancer, also referred to as metastatic cancer, is cancer that has spread from its original site to other parts of the body. It is different from primary cancer, which originates in one location. The video explains how to code secondary cancers and emphasizes the importance of sequencing them first when they are the focus of treatment.

💡In Situ

In situ neoplasms are abnormal cell growths that are confined to the site of origin and have not invaded nearby tissue. They can be benign or, in some cases, malignant. The video clarifies that in situ neoplasms are distinct from primary and secondary cancers and have specific coding in the ICD-10 CM system.

💡Benign

Benign neoplasms are abnormal growths that are non-cancerous and do not invade nearby tissue or spread to other parts of the body. They are less dangerous than malignant neoplasms but may still require medical attention. In the video, benign neoplasms are one of the classifications discussed for coding purposes.

💡Uncertain Behavior

Uncertain behavior neoplasms are those for which the healthcare provider cannot determine whether the growth is malignant or benign. These neoplasms require specific coding in the ICD-10 CM system to reflect the unknown nature of the tumor.

💡Unspecified

Unspecified neoplasms are those cases where there is insufficient information in the medical record to assign a specific code. This category is used when the nature of the tumor is not clearly documented or known. The video emphasizes the importance of accurate documentation for proper coding.

💡Coding Guidelines

Coding guidelines are the rules and instructions provided for classifying medical diagnoses and procedures using a standardized coding system like ICD-10 CM. These guidelines ensure consistency and accuracy in medical coding practices. The video focuses on the application of these guidelines for coding neoplasms, including the sequencing of primary and secondary cancers.

💡Sequence

In the context of medical coding, sequence refers to the order in which multiple diagnoses or procedures are recorded and reported. Proper sequencing is crucial for accurate billing and understanding the primary focus of treatment. The video discusses the importance of sequencing secondary cancers before primary cancers when they are the reason for treatment.

💡Medical Coding

Medical coding is the process of converting healthcare diagnoses, procedures, and other services into standardized code forms. This is essential for healthcare record-keeping, billing, and statistical analysis. The video is a tutorial on medical coding, specifically focusing on the coding of neoplasms using ICD-10 CM chapter 2.

Highlights

Discussion on ICD-10 CM chapter 2 neoplasms and the importance of watching TAP lectures for better understanding.

Overview of the six classifications of neoplasms: primary cancer, secondary cancer, insitu, benign, uncertain, and unspecified.

Explanation of how cancer evolves from normal cells to metastatic disease, emphasizing the transition from benign to malignant cells.

Instructions on how to use the MCG manual and Vimeo for accessing TAP lectures and other resources.

Detailed walk-through on how to find and verify ICD-10 CM codes for neoplasms using the neoplasms table in the ICD-10 CM manual.

Clarification on the default coding for primary cancer when no mention of secondary cancer is present.

Example coding scenario for a patient with prostate cancer, explaining the process of finding the correct ICD-10 CM code.

Discussion on the arrangement of neoplasms codes in the ICD-10 CM table, highlighting that they are organized alphabetically.

Another coding example involving a patient with primary cancer of the left bronchus and metastasis to the hip bone, demonstrating the coding process for multiple conditions.

Explanation of the importance of verifying codes in the tabular list after finding them in the neoplasms table.

Guidelines for sequencing codes when dealing with multiple cancers, emphasizing that the secondary (metastatic) cancer should be sequenced first if that is what is being treated.

Advice on using the MCG manual to understand and apply coding guidelines for neoplasms, including tips for accessing the manual and finding specific chapters.

Emphasis on the practical application of coding guidelines in real-world scenarios, such as determining the correct sequence of codes based on the patient's treatment focus.

Encouragement for coders to engage with the material, ask questions, and seek clarification to improve their understanding of ICD-10 CM coding for neoplasms.

Closing remarks that summarize the key points of the discussion and encourage continued learning and application of the coding guidelines.

Transcripts

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Related Tags

ICD10CM NeoplasmClassification CancerCoding MedicalBilling PrimaryCancer SecondaryCancer CodingGuidelines HealthcareEducation MCGManual TapLecture