Testicular Cancer with Brain, lung, liver and spine mets

dorothy.schulte@att.net

Patient has testicular cancer diagnosed 15 years ago, bilateral lung mets in 2015 and patient had chemo at that time. Patient has Brian, liver, spine mets. Bilateral craniotomy 3/17/17 for resection frontal lobe tumors, there is no wound care currently being done. anxiety, depression, weakness dizziness, headache, abnormal gait. Would you change anything in the coding below?


A. C79.31 Brain mets
B. C78.7 Liver mets
C. C79.89 SPine mets
D. C78.01 Right lung mets
E. C78.02 Left lung mets
F. Testicular Cancer C62.9
G. Headache
H. Abnormal gait
I. Weakness
J. Anxiety
K. Depression

Thanks,
Dorothy

SusanWinokur

What is the main focus of skilled care?
Did the patient have orchiectomy?

Susan Winokur, HCS-D, BCHH-C | Southwest Medical
Part of OptumCare
Senior Medical Coder, Home Health

8655 South Eastern Avenue, Las Vegas, NV 89123 USA
T    +1 702-838-0644
Susan.Winokur@optum.com
smalv.com

dorothy.schulte@att.net

Therapy for the weakness and abnormal gait. The patient has been in and out of the hospital due to the brain mets.

SusanWinokur

Sequencing of codes should reflect the Plan of Care, so I would sequence first the primary cause for the weakness and gait issue. If from prolonged hospitalization/immobility, sequence them before the cancer codes. If weakness and gait problem are related to the brain mets, sequence brain mets first. Use "history of" for the testicular cancer if treated with surgical removal of the testes.

Susan Winokur, HCS-D, BCHH-C | Southwest Medical
Part of OptumCare
Senior Medical Coder, Home Health

8655 South Eastern Avenue, Las Vegas, NV 89123 USA
T    +1 702-838-0644
Susan.Winokur@optum.com
smalv.com

dorothy.schulte@att.net

Thanks so much Susan.