Hello,
I have a patient who was involved in rescue efforts at the Twin Towers on 9/11. He subsequently developed cancer on his palate. The patient had surgery to remove the cancer, but this left a defect that needed surgery at a later date. That’s where our plastic surgeon came into the picture. He repaired the defect in the palate with the diagnosis codes K13.79 Other lesions of oral mucosa, K13.29 Other disturbances of oral epithelium, including tongue, Z42.8 Encounter for other plastic/reconstruction surgery following medical procedure or healed injury, Z85.09 Personal history of malignant neoplasm of digestive organs. This payer will not accept any diagnosis other than the C05.1 Malignant neoplasm of soft palat, however, the cancer is not present anymore. It is my understanding that once the cancer is removed it cannot be coded anymore.
I have a patient who was involved in rescue efforts at the Twin Towers on 9/11. He subsequently developed cancer on his palate. The patient had surgery to remove the cancer, but this left a defect that needed surgery at a later date. That’s where our plastic surgeon came into the picture. He repaired the defect in the palate with the diagnosis codes K13.79 Other lesions of oral mucosa, K13.29 Other disturbances of oral epithelium, including tongue, Z42.8 Encounter for other plastic/reconstruction surgery following medical procedure or healed injury, Z85.09 Personal history of malignant neoplasm of digestive organs. This payer will not accept any diagnosis other than the C05.1 Malignant neoplasm of soft palat, however, the cancer is not present anymore. It is my understanding that once the cancer is removed it cannot be coded anymore.
Thank you for any insight you can provide.
Mary