ICD-10 Coding for History of Colon Carcinoma(Z85.038)
Complete ICD-10-CM coding and documentation guide for History of Colon Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Colon Carcinoma
Key Information: ICD-10 code for history of colon cancer
Essential facts and insights about History of Colon Carcinoma
Primary ICD-10-CM Code for history of colon carcinoma
Decision Criteria
clinical Criteria
- No evidence of active disease post-treatment
documentation Criteria
- Operative and surveillance reports confirming no active disease
Applicable To
- History of colon cancer
Excludes
- Current colon cancer (C18.x)
Clinical Validation Requirements
- Operative report confirming resection
- Surveillance imaging report stating 'NED'
- Undetectable CEA levels
Code-Specific Risks
- Misclassification if active treatment is ongoing
Coding Notes
- Ensure documentation clearly states the cancer is no longer active.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Colon Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z85.038.
Impact
Clinical: Misinterpretation of patient's cancer status, Regulatory: Potential audit issues, Financial: Incorrect billing for surveillance
Mitigation Strategy
Use specific terms like 'personal history of colon cancer', Include treatment and surveillance details
Impact
Reimbursement: Incorrect reimbursement for active treatment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate patient records
Mitigation Strategy
Use C18.x codes for active cancer cases.
Impact
Using Z85.038 for patients still undergoing treatment.
Mitigation Strategy
Verify treatment completion and current disease status before coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for History of Colon Carcinoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Colon Carcinoma
Use these documentation templates to ensure complete and accurate documentation for History of Colon Carcinoma. These templates include all required elements for proper coding and billing.
Post-treatment surveillance
Specialty: OncologyRequired Elements
- Cancer history
- Treatment details
- Current status
- Surveillance plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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