Lung Cancer - Insights into Medical Coding

Lung Cancer - Insights into Medical Coding

Lung cancer is a leading cause of death in the United States. Radiology medical coding is a major challenge that oncologists face.

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Lung cancer is a major cause of death in the United States. The two most common risk factors for lung cancer are Increasing age and exposure to tobacco smoke. After diagnosis, only 16.8% of people in the United States survive for five years. Smoking is the primary cause of lung cancer while passive smoking, exposure to radon gas and asbestos. Genetic factors are the rarer causes of this cancer.

Screening for Lung Cancer Many cases of lung cancer are detected only after the cancer has progressed further.

That’s because the classic symptoms such as wheezing, coughing blood, shortness of breath, etc., sometimes manifest only at a later stage. Surgery, or surgery combined with chemotherapy and radiation or any one of these are the treatment options.

Radiology medical coding is a major challenge that oncologists face. One positive outcome is that CMS has decided to reimburse lung cancer screening as a preventive service, subject to two conditions: -

For patients: mandatory screening, counseling and a shared decision-making visit with the patient’s physician

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For radiologists: Collection and submission of CT screenings data to a CMSapproved national registry for each low-dose CT lung cancer screening exam performed

Lung Cancer ICD-10 Diagnostic Codes The 2015-2016 ICD-10 diagnostic codes for lung cancer are as follows: C34 is the code for malignant neoplasm affecting bronchus and lung. The codes for specific lung cancer conditions are as follows:

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C34.10 – Malignant neoplasm affecting upper lobe or unspecified lung or bronchus

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C34.11 – Malignant neoplasm of upper lobe, right bronchus or lung

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C34.12 – Malignant neoplasm of upper lobe, left bronchus or lung

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C34.2 – Malignant neoplasm affecting middle lobe, lung or bronchus

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C34.31 & C34.32 – Malignant neoplasm affecting lower lobe, right lung or bronchus (C34.31) and left lung or bronchus (C34.32)

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C34.80 – Malignant neoplasm affecting overlapping sites of unspecified lung and bronchus

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C34.81 & C34.82 – Malignant neoplasm affecting overlapping site of right (C34.81) and left (C34.82) bronchus and lung

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C34.90 – Malignant neoplasm of unspecified part of unspecified bronchus or lung

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C34.91 & C34.92 – Malignant neoplasm affecting unspecified part of right (C34.91) and left (C34.92) bronchus or lung

Lung Cancer Treatment Codes Treatment for lung cancer obviously depends on kind of cancer and the stage of development it is in as well as the general health of the individual. Surgery, chemotherapy and radiotherapy are the usual treatment options and sometimes the three are used in combination. Biological therapy is also used in the case of non small cell cancer in its advanced stage.

Here are the CPT treatment codes: 99221 – 99239: For Hospital Inpatient Services 96401 – 96549: For Chemotherapy Administration

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Administering chemotherapy through push technique – 96409 and 96420

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Chemotherapy through infusion – 96413 and 96422

These are reimbursed when they are billed for the same day. Only a single intravenous push procedure (96409) and a single intra-arterial push procedure (96420) are permitted each day even if separate drugs are administered.

77401: For Radiation Treatment Researching More Effective Treatment According to latest research published in Molecular Cell journal and revealed in the News Medical website, there could be a more effective way to stop the growth of cancer cells. Researchers have found that cutting the alternative nutrition sources of cancer cells could hinder their growth. Scientists first identified the metabolic programs through which cancer cells grow. This research could particularly contribute to more successful lung cancer treatment. Lung cancer is responsible for over a quarter of cancer deaths.

As you know, cancer cells go through a metabolism process that is different from that of regular cells. The rapid proliferation of cancer cells causes their energy requirements to increase as well. The cells meet this need through the intake of glucose. Glucose is used ten or hundred times by cancer cells than normal cells. Eventually glucose gets scarce and cancer cells need to seek alternative nutrition sources for maintaining growth and survival. Experimentation was particularly conducted on non-small cell lung cancer that affects around 90% of all cases of lung cancer. Researchers found that scarcity of glucose leads cancer cells to switch to glutamine, an amino acid. This change in

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metabolism is caused by the PEPCK enzyme, researchers have found. Blocking PEPCK in the cancer cells has been found by researchers to slow the growth of tumor in mice.

Progress in research can make treatment for lung cancer more effective. When it comes to reimbursement, relying on professional medical coding services is the best option.

Physician documentation in the medical record and application of the Official Coding Guidelines for screening and inpatient care are critical aspects in the coding and sequencing for lung cancer. In addition, adherence to the specific AHA Coding Clinic for ICD-10-CM and AMA CPT Assistant references is necessary to ensure complete and accurate coding. Professional radiology medical coding services can take care of this.

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