Q&A Neoplasm guideline NEC*

[Marcie S]

I watched the Blitz video on ICD-9 and I am still confused about this. I understand the concept, but I am obviously missing something. Back NEC* is 195.8 (primary) and 198.89 (secondary), but Skin, back is 173.50 (primary) and 198.2 (secondary). Why are these two codes not the same if Back NEC is to be coded as Skin, back (whether primary or secondary). Can you help me better understand this with an example/scenario. Thanks so much.
Marcie

 

[Alicia Scott]

I think the easiest way to understand and remember is that skin is an organ. The back is not. Does that help?

 

[Marcie S]

Maybe. Are the guidelines trying to tell me - "Hey, if the diagnosis is primary squamous cell carcinoma or epidermoid carcinoma of the Back, then you would code it Skin, back, malignant squamous cell carcinoma (primary 173.52) or epidermoid carcinoma (primary 173.59), but if the diagnosis is papilloma back then you would code it Skin, back, benign (216.5). However, if the diagnosis is basal cell carcinoma back malignant primary, then you would code it 195.8." Is that right? With these guidelines/scenario when would I code the Skin, back, basal cell carcinoma malignant primary (173.91)?