Chapter 6

Question 1

neoplasm

Answer 1

abnormal tissue growth; tumor

Question 2

mass

Answer 2

abnormal collection of tissue

Question 3

carcinoma

Answer 3

a malignant neoplasm or cancerous tumor

Question 4

malignant

Answer 4

invasive and destructive characteristic of a neoplasm; possibly causing damage or death

-cancerous

Question 5

benign

Answer 5

nonmalignant characteristic of a neoplasm; not infectious or spreading

-not cancerous

Question 6

metastasize

Answer 6

to proliferate, reproduce, or spread

Question 7

functional activity

Answer 7

glandular secretion in abnormal quantity

Question 8

topography

Answer 8

the classification of neoplasms primarily by anatomical site

Question 9

morphology

Answer 9

the study of the configuration or structure of living organisms

Question 10

overlapping boundaries

Answer 10

multiple sites of carcinoma without identifiable borders

Question 11

ectopic

Answer 11

out of place such as an organ or body part

Question 12

List 4 Reasons why a patient might come in for a screening test

Answer 12

1. calendar- such as an annual
2. age- such as 50 years (colonoscopy)
3. family history- such as mother had been diagnosed
4. personal history- such as a patient had this before

Question 13

When are diagnostic tests done?

Answer 13

• patient exhibits signs and symptoms of a condition

- test is needed to confirm or deny physician’s diagnostic suspicion

Question 14

Neoplasms may be defined by and individual name. List some examples

Answer 14

• adenoma
• melanoma
• leukemia
• papilloma

Question 15

What are different categories of tumors (4)?

Answer 15

• malignant
• benign
• carcinoma in situ
• uncertain

Question 16

Carcinoma in situ

Answer 16

• encapsulated in a specific organ

- the believe to have removed it from said location

Question 17

uncertain

Answer 17

pathologist has looked at the tissue and behavioral characteristics are uncertain (unclear)

Question 18

Malignant Primary

Answer 18

indicates the anatomical site (the place in the body) where the malignant neoplasm was first seen and identified

Question 19

Malignant Secondary

Answer 19

identifies the anatomical site to which the malignancy metastasized

Question 20

When coding where do you find the codes that you need to report (2)?

Answer 20

neoplasm table

alphabetic index

Question 21

What do you need to know to determine the code to report a neoplasm (3)?

Answer 21

1. where in the body (specififically which anatomical site) is the neoplasm located?
2. is the neoplasm benign, malignant, ca in situ, or uncertain?
3. if the neoplasm is malignant, is the first diagnosis of malignancy for this patient?
   
   • if so, this is the primary site
   • if not, this is a secondary malignancy (metastasized from the primary site)

Question 22

unspecified behavior

Answer 22

doctor has not specified if the neoplasm

• query the physician

Question 23

Can you code right from the Neoplasm table without checking the tabular index?

Answer 23

yes

Question 24

Can you use a pathology report when coding neoplasms? why?

Answer 24

yes.

a pathologist is a physician

Question 25

When a pregnant woman is diagnosed with a malignancy, how might you code that?

Answer 25

a code from code subcategory O9A.1-Malignant neoplasm complicating pregnancy, childbirth and the puerperium will be reported as the principal diagnosis, followed by the code for the primary malignancy

Question 26

Is a patient in remission and a patient with a personal history of the same thing?

Answer 26

No.

If the documentation is not absolutely clear on this, you must query the physician for clarification.

Question 27

Functional Activity
(important chapter notes)

Answer 27

“All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from chapter 4 may be used to identify such functional activity associated with any neoplasm.”

Question 28

Morphology (histology)

important chapter notes

Answer 28

“Chapter 2 classifies neoplasms primarily by site (topography) with broad groupings for behavior, malignant, in situ, benign, ect. The Table of Neoplasms should be used to identify the correct topography code. In a few cases such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category codes

Question 29

Primary Malignant Neoplasms Overlapping Site Boundaries

Answer 29

“A primary malignant neoplasm that overlaps two or more contiguous (next to each other)sites should be classified to the subcategory/code 8 (“overlapping lesion”), unless combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.”

Question 30

Malignant Neoplasm of Ectopic Tissue

important chapter notes

Answer 30

“Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g. ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9)

Question 31

If the encounter is only for therapeutic treatment of a malignancy, such as the administration of Chemotherapy, immunotherapy, or radiation therapy, What will the principle (first-listed) code be? What will it be followed by?

Answer 31

Principle code will report the therapeutic treatment of a malignancy

followed by a code or codes to report the details about the malignancy being treated.

Question 32

After a surgical procedure to remove the malignancy, the patient no longer has the anatomical site where the malignancy was located. Therefore, the patient can no longer have that condition.

How is the code we report affected?

Answer 32

Thereafter, the code will change from a malignancy code (C00-C96) to a personal history of a malignancy code (category Z85)

Question 33

If a patient is admitted for treatment of anemia manifested from malignancy, and only the anemia is treated during this stay. How would you code this?

Answer 33

Report the code for the neoplasm as the principle diagnosis FOLLOWED by code D63.0 Anemia in neoplastic disease

Question 34

If a patient is admitted for treatment of dehydration manifested from malignancy, and only the dehydration is treated during this stay, How would you code this?

Answer 34

Report the code for the dehydration as the principle diagnosis followed by the code for the neoplasm that was the reason the treatment was needed.

Question 35

Admission for radiation, chemotherapy, or immunotherapy, develops complications during the encounter, how would you code this?
(Complications of treatment)

Answer 35

Report Z51.0, Z51.11, or Z51.12 as the principal diagnosis code FOLLOWED by the code (S) to report the specific complications

Question 36

Admission for treatment of Anemia resulting from chemotherapy or immunotherapy- how would you code this?
Complications of treatment

Answer 36

report a code for the anemia first, FOLLOWED by adverse effect code

Question 37

Admission for treatment of anemia resulting from radiation treatments- how would you code this?
Complications of treatment

Answer 37

report a code for the anemia first, followed by neoplasm code, followed by Y84.2

Question 38

In the Treatment of the Secondary Site Only, how would you report this?

Answer 38

report the secondary site as the principle diagnosis followed by the primary site malignancy code