If a patient has a history of colon cancer, it can considerably put him at risk of getting the condition. Normally, a high-risk patient would carry a medical history that includes polyps, inflammatory bowel disease, or certain colorectal cancers.
ICD-9 way: At present, you code personal history of colorectal cancer with V10.05 (Personal history of malignant neoplasm of large intestine).
ICD-10 difference: However, when ICD-9-CM becomes ICD-10-CM in Oct. 1, 2013, you would instead use Z85.038 (Personal history of other malignant neoplasm of large intestine). Note that the new code has the same descriptor — except for the word “other” — so you should regard ICD-10 code Z85.038 the same way as you do the ICD-9 code V10.05.
Documentation: According to ICD-10-CM, Z85.038 is applicable to conditions classifiable to parent code C18 (Malignant neoplasm of colon), which includes ‘child’ codes such as:
- C18.0 — Malignant neoplasm of cecum
- C18.1 — Malignant neoplasm of appendix
- C18.2 — Malignant neoplasm of ascending colon
- C18.3 — Malignant neoplasm of hepatic flexure
- C18.4 — Malignant neoplasm of transverse colon
- C18.5 — Malignant neoplasm of splenic flexure
- C18.6 — Malignant neoplasm of descending colon
- C18.7 — Malignant neoplasm of sigmoid colon
- C18.8 — Malignant neoplasm of overlapping site
- C18.9 — Malignant neoplasm of colon, unspecified.
Tips: As per ICD-9 guidelines, you should use history codes (i.e., V10.05) as the reason for an encounter when a condition needs to be monitored for recurrence. You will follow the same guidelines for history codes when ICD-10 begins on Oct. 1, 2013.
Example: When a colorectal cancer is present, you will use an ICD-10 code for malignant neoplasm of the large intestine (C18.3-C18.9 for various sites in the colon, and C19-C21.8 for various sites in the rectum, rectosigmoid junction, and anus). After the cancer discovered is removed, and the patient returns for follow-up visits or for a surveillance colonoscopy, you will bill Z85.038 or Z85.048 (Personal history of other malignant neoplasm of rectum, rectosigmoid junction, and anus).