Medicare Compliance & Reimbursement - 2010 Issue 12
Reader questions: 153.3 Vs. V10.05 -- Get the History Right
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Article Overview
This article addresses a reader question about coding an encounter after treatment for colon cancer has ended and the patient is returning for follow-up related to prior surgery and a mediport. It explains the general distinction between an active cancer diagnosis and a history-of-cancer diagnosis in an office visit context, and it notes the importance of selecting the correct reason for the encounter. The piece is aimed at medical coders, billers, and revenue cycle staff who need help interpreting diagnosis selection for postoperative and post-treatment visits.
Why This Topic Matters
Diagnosis selection can affect whether an encounter is understood as active disease management or as follow-up after treatment completion. Accurate classification supports cleaner claims and more consistent documentation review.
What You Will Learn
- How follow-up encounters after cancer treatment completion are generally categorized
- Why distinguishing current disease from past cancer history matters for office visit coding
- How postoperative and device-removal follow-up context can affect diagnosis selection
- When a family history category is not the appropriate choice for the scenario discussed
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Coding auditors
- Physician office staff
Codes Discussed
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