E/M Coding Alert - 2017 Issue 4
Reader Question: Don't Make Assumptions About Cancer History
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Article Overview
This short article addresses how to think about a patient’s past cancer treatment when the current visit is for follow-up or surveillance rather than new symptoms. It is aimed at coders and billing staff who need to understand the broad ICD-10-CM categories involved and why payer policy review may be important.
Why This Topic Matters
Correctly distinguishing active disease from personal history and follow-up scenarios affects diagnosis reporting, claim accuracy, and compliance with payer-specific requirements.
What You Will Learn
- How this scenario is framed in terms of follow-up versus history documentation
- Which ICD-10-CM category of diagnoses is discussed for prior malignant neoplasm history
- Why payer policies may affect diagnosis sequencing or acceptance of the follow-up code
- How the article approaches coding when no new symptoms are reported
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Coding auditors
- Physician office staff
Codes Discussed
Code Ranges Discussed
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