neoplasm with cancerous tumor wound

edrobinson@regmed.comedrobinson@regmed.com
in Home Care Coding General
Hi,

Patient has stage 4 (L) breast cancer. The cancerous tumor has become a open wound that starts at the (L) breast and extends to the axilla and (L) upper back. My question is do I only code c50.912 or do I also need to code a "open wound" code? She is also in pretty severe pain secondary to the neoplasm. No surgery has been done for this patient at this time.

Thanks in advance,
Heather Bonnette

Comments

  • Unknown
    edited April 2017
    I have a note in my book to code L98.499 for wounds r/t breat cancer. There is a pain code for neoplasm related pain G89.3.


    Brandy Slate, RN, HCS-D, COS-C

    Chief Operating Officer

    Codes Correct

    off: (903) 549-2115

    c: (903) 724-3131

    f: (866) 564-2312

    brandy.slate@codescorrect.com
  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited April 2017
    Hi Heather.
    First off you are describing not only left upper outer quadrant, but also the Axillary Tail. These are contiguous sites, overlapping. I found the code C50.82.
    Also, your claim will lose out monies if you use an "unknown" code such as C50.9 category codes (unspecified site codes)
    As for the neoplastic ulcer formed I would go with Brandy's suggestion.

    Nancy Wolverton RN,CCM
    QR Specialist, Central Office
    5800 West 10th St., Suite 300
    Little Rock, AR. 72205
    Ph# 501-280-4913
    Fax# 501-280-4385
    Nancy.Wolverton@arkansas.gov
  • lkpengellkpengel
    edited April 2017
    * Coding Tips (L98.49)
    Locally advanced, metastatic or recurrent cancer may infiltrate the skin, disrupt its integrity, and cause chronic, poorly healing, and fungating wounds. When an ulcer/wound is the result of cancer, code only the cancer.
  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited April 2017
    Found the tip too.
    Good call Lisa.
    Wonder if this might be a case for using the Att'n to Non-Surgical Wound?

    Nancy Wolverton RN,CCM
    QR Specialist, Central Office
    5800 West 10th St., Suite 300
    Little Rock, AR. 72205
    Ph# 501-280-4913
    Fax# 501-280-4385
    Nancy.Wolverton@arkansas.gov
  • Unknown
    edited April 2017
    My tip says just the opposite. A fulminating ulcer resulting from breast cancer may be coded as breast cancer and L98.49-.............. How odd.



    Brandy Slate, RN, HCS-D, COS-C

    Chief Operating Officer

    Codes Correct

    off: (903) 549-2115

    c: (903) 724-3131

    f: (866) 564-2312

    brandy.slate@codescorrect.com
  • dreadrewdreadrew
    I don't see that tip.... is it in DH book? what page? I have a tip that says to use L98.49- for breast cancer
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