c. Personal History of Malignant Neoplasm. In addition to the categories for
malignant neoplasm provided in chapter 2, ICD -9-CM contains codes in the
supplementary classification for describing history of (primary) malignant neoplasm
(codes V1.-V1.9), and for describing the purpose of an encounter as for
radiotherapy (code V58.) and for maintenance chemotherapy (code V58.1).
d. Categories 150 and 201 contain a departure from the usual princi ples of
classification in that the fourth -digit subdivisions in each case are not mutually
exclusive. In each instance, the dual axis is provided to account for differing
terminology encountered on source documents; for example, one surgeon may describe
the location of an esophageal malignancy as cervical portion, while another may say
upper third.
e. Neoplasms with Overlapping Site Boundaries. Categories 140-195 are for
the classification of primary malignant neoplasms according to their point of origin. A
primary malignant neoplasm whose point of origin cannot be determined but whose
stated sites overlaps two or more subcategories within a three -digit category should be
classified to the four-digit subcategory .8 (other). For certain malignant neoplasms
whose point of origin cannot be determined but whose stated sites overlap two or more
three-digit categories, codes for contiguous sites are provided. These codes are 149.8,
159.8, and 165.8. Overlapping malignant neoplasms that cannot be classified as
indicated above should be assigned to the appropriate subdivision of category 195
(Malignant neoplasm of other and ill-defined sites).
2. Coding Principles.
a. Primary Site is Still Present (Solid Tumors). For example, the hospital
admission during which the malignancy is diagnosed or during which the primary
treatment took place. Code the primary site using codes from chapter 2 (codes
14.-195.9). If present, code also secondary sites which may be present using
categories 196-199.
b. Primary Site Previously Treated (Solid Tumors). The primary site was
previously excised or eradicated with no recurrence of original primary site. If a
neoplasm is eradicated on a previous admission, regardless of the length of time since
eradication, the neoplasm should not be coded as being present unless there has been
a recurrence. An eradicated neoplasm is one that has been removed by surgical
procedure or otherwise destroyed through other treatment. To note the eradicated
neoplasm in the present record, code a personal history of a malignant neoplasm.
(1) Code the primary site using codes from the supplementary classification
(codes V1.-V1.9). These codes will never appear as the cause of admission
diagnosis.
(2) If the patient has secondary sites present, code these using categories
196-199. Also code the previous primary site code (V1. -V1.9).
(3) If the patient has no secondary malignancy, and if the reason for admission
is follow-up of the malignancy, code to V67. Also code the previous primary site
(V1.-V1.9).
MD0753
A-24