If a doctor states they are treating grade 1 follicular lymphoma, b-cell type. Would you use an icd 10 code from the c82 section or from c85 section?
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Tag Archives: lymphoma
Coding for Recurrent Lymphoma
:confused: I work for a Hematology/Oncology practice. The patient was said to have Stage IV indolent low grade B-cell lymphoma with associated splenic and bone marrow involvement (due to progressive splenomegaly) and pancytopenia. The doctor marked it as an Extranodal marginal zone B-Cell lymphoma of MALT type and started him on Bendamustine + Rituximab and Peglilgrastim. The patient subequently underwent a splenectomy which pathology showed no evidence of lymphoproliferative disorder or evidence of malignancy. The patient now has a recurrence in the cervical nodes.
I have two questions: First, should this have originally been coded as a NHL (C83.80), MZLS (C83.07) or Extranodal Marginal zone B-Cell Lymphoma, MALT type (C88.4)?
Second, since lymphomas are systemic, hey can be billed as a secondary disease, how should this recurrence be coded for the cervical nodes? Marginal Zone Lymphoma HFN (C83.01) or as one of the code listed above?
Please help! Thank you.
CPT code for lymphoma workup needle core biopsy vs biopsy
Good Morning All!
A question was brought up by one of our pathologists concerning lymphoma workups for needle core biopsies vs biopsy – We have been upcoding lymph node biopsies for lymphoma work ups to an 88307 but for the needle core biopsies, we have been keeping them as an 88305. The pathologist looked through Paget’s and couldn’t find any reasoning as to why we should keep a needle core to a 305 – I have included the email for better clarity – Anyone have any thoughts on this?
A question was brought up by one of our pathologists concerning lymphoma workups for needle core biopsies vs biopsy – We have been upcoding lymph node biopsies for lymphoma work ups to an 88307 but for the needle core biopsies, we have been keeping them as an 88305. The pathologist looked through Paget’s and couldn’t find any reasoning as to why we should keep a needle core to a 305 – I have included the email for better clarity – Anyone have any thoughts on this?
"Do you recall the reasoning for that? From my reading, I believe we should code 88307 for lymphoma work-up any time flow is done on the same node and/or IHC (to evaluate for a lymphoma) is done both of which were done on this specimen. I didnt see anything in the coding services handbook that would indicate whether it is a core biopsy vs excisional biopsy would make any difference.
The extra work that must be documented will include
at least one of the following: touch preparation or frozen section to assess specimen adequacy
and determine what, if any, special studies are appropriate; H&E sections beyond the number
typically associated with a lymph node biopsy; flow cytometry immunophenotyping; molecular
pathology; and/or immunohistochemistry."