Oct 01, 2021 · Personal history of malignant neoplasm of prostate. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code Male Dx POA Exempt. Z85.46 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z85.46 became effective on October 1, 2021.
History of cancer of the prostate; History of malignant neoplasm of prostate; History of radiation therapy for prostate cancer. ICD-10-CM Diagnosis Code Z85.46. Personal history of malignant neoplasm of prostate. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code Male Dx …
History of cancer of the prostate; History of malignant neoplasm of prostate; History of radiation therapy for prostate cancer. ICD-10-CM Diagnosis Code Z85.46. Personal history of malignant neoplasm of prostate. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code Male Dx …
ICD-10 code Z85.46 for Personal history of malignant neoplasm of prostate is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.
Z85.46 is a billable diagnosis code used to specify a medical diagnosis of personal history of malignant neoplasm of prostate. The code Z85.46 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.#N#The ICD-10-CM code Z85.46 might also be used to specify conditions or terms like history of malignant neoplasm of prostate. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.#N#The code Z85.46 is applicable to male patients only. It is clinically and virtually impossible to use this code on a non-male patient.
Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.
Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
The options include watchful waiting, surgery, radiation therapy, hormone therapy, and chemotherapy. You may have a combination of treatments. NIH: National Cancer Institute.
To diagnose prostate cancer, you doctor may do a digital rectal exam to feel the prostate for lumps or anything unusual. You may also get a blood test for prostate-specific antigen (PSA). These tests are also used in prostate cancer screening, which looks for cancer before you have symptoms. If your results are abnormal, you may need more tests, such as an ultrasound, MRI, or biopsy.
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status
The 2022 edition of ICD-10-CM Z85.858 became effective on October 1, 2021.
Z85.49 is a billable diagnosis code used to specify a medical diagnosis of personal history of malignant neoplasm of other male genital organs. The code Z85.49 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.
The options include watchful waiting, surgery, radiation therapy, hormone therapy, and chemotherapy. You may have a combination of treatments.
You may also get a blood test for prostate-specific antigen (PSA). These tests are also used in prostate cancer screening, which looks for cancer before you have symptoms. If your results are abnormal, you may need more tests, such as an ultrasound, MRI, or biopsy. Treatment often depends on the stage of the cancer.
Priapism - a painful erection that does not go away
Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Problems passing urine, such as pain, difficulty starting or stopping the stream, or dribbling
V10.46 is a legacy non-billable code used to specify a medical diagnosis of personal history of malignant neoplasm of prostate. This code was replaced on September 30, 2015 by its ICD-10 equivalent.
You may also get a blood test for prostate-specific antigen (PSA). These tests are also used in prostate cancer screening, which looks for cancer before you have symptoms. If your results are abnormal, you may need more tests, such as an ultrasound, MRI, or biopsy. Treatment often depends on the stage of the cancer.
Low back pain. Pain with ejaculation. To diagnose prostate cancer, you doctor may do a digital rectal exam to feel the prostate for lumps or anything unusual.
Prostate Cancer. The prostate is the gland below a man's bladder that produces fluid for semen. Prostate cancer is common among older men. It is rare in men younger than 40. Risk factors for developing prostate cancer include being over 65 years of age, family history, and being African-American.
Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
For more context, consider the meanings of “current” and “history of” (ICD-10-CM Official Guidelines for Coding and Reporting; Mayo Clinic; Medline Plus, National Cancer Institute):#N#Current: Cancer is coded as current if the record clearly states active treatment is for the purpose of curing or palliating cancer, or states cancer is present but unresponsive to treatment; the current treatment plan is observation or watchful waiting; or the patient refused treatment.#N#In Remission: The National Cancer Institute defines in remission as: “A decrease in or disappearance of signs or symptoms of cancer. Partial remission, some but not all signs and symptoms of cancer have disappeared. Complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body.”#N#Some providers say that aromatase inhibitors and tamoxifen therapy are applied during complete remission of invasive breast cancer to prevent the invasive cancer from recurring or distant metastasis. The cancer still may be in the body.#N#In remission generally is coded as current, as long as there is no contradictory information elsewhere in the record.#N#History of Cancer: The record describes cancer as historical or “history of” and/or the record states the current status of cancer is “cancer free,” “no evidence of disease,” “NED,” or any other language that indicates cancer is not current.#N#According to the National Cancer Institute, for breast cancer, the five-year survival rate for non-metastatic cancer is 80 percent. The thought is, if after five years the cancer isn’t back, the patient is “cancer free” (although cancer can reoccur after five years, it’s less likely). As coders, it’s important to follow the documentation as stated in the record. Don’t go by assumptions or averages.
According to the ICD-10 guidelines, (Section I.C.2.m):#N#When a primary malignancy has been excised but further treatment, such as additional surgery for the malignancy, radiation therapy, or chemotherapy is directed to that site, the primary malignancy code should be used until treatment is complete.#N#When a primary malignancy has been excised or eradicated from its site, there is no further treatment (of the malignancy) directed to that site, and there is no evidence of any existing primary malignancy, a code from category Z85, Personal history of malignant neoplasm, should be used to indicate the former site of the malignancy.#N#Section I.C.21.8 explains that when using a history code, such as Z85, we also must use Z08 Encounter for follow-up examination after completed treatment for a malignant neoplasm. This follow-up code implies the condition is no longer being actively treated and no longer exists. The guidelines state:#N#Follow-up codes may be used in conjunction with history codes to provide the full picture of the healed condition and its treatment.#N#A follow-up code may be used to explain multiple visits. Should a condition be found to have recurred on the follow-up visit, then the diagnosis code for the condition should be assigned in place of the follow-up code.#N#For example, a patient had colon cancer and is status post-surgery/chemo/radiation. The patient chart notes, “no evidence of disease” (NED). This is reported with follow-up code Z08, first, and history code Z85.038 Personal history of other malignant neoplasm of large intestine, second. The cancer has been removed and the patient’s treatment is finished.
History of Cancer: The record describes cancer as historical or “history of” and/or the record states the current status of cancer is “cancer free,” “no evidence of disease,” “NED,” or any other language that indicates cancer is not current. According to the National Cancer Institute, for breast cancer, the five-year survival rate ...
The fear is, history of will be seen as a less important diagnosis, which may affect relative value units . Providers argue that history of cancer follow-up visits require meaningful review, examinations, and discussions with the patients, plus significant screening and watching to see if the cancer returns.