ICD-10 Coding for History of Throat Cancer(Z85.818, Z85.819)
Complete ICD-10-CM coding and documentation guide for History of Throat Cancer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Throat Cancer
Z85.81-Z85.89Primary Range
Personal history of malignant neoplasm of other sites
This range includes codes for personal history of malignant neoplasms, specifically Z85.818 for specified sites of the lip, oral cavity, and pharynx.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z85.818 | Personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx | Use when the patient has a documented history of throat cancer with no active disease and treatment is completed. |
|
| Z85.819 | Personal history of malignant neoplasm of unspecified sites of lip, oral cavity, and pharynx | Use when the patient has a history of throat cancer but the specific site is not documented. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: When does active throat cancer become history?
Essential facts and insights about History of Throat Cancer
Primary ICD-10-CM Codes for history of throat cancer
Decision Criteria
clinical Criteria
- Patient has completed treatment and is in remission.
documentation Criteria
- Specific site of previous cancer is documented.
Applicable To
- History of nasopharyngeal cancer
- History of oropharyngeal cancer
- History of hypopharyngeal cancer
Excludes
- Active malignant neoplasm of pharynx (C10-C14)
Clinical Validation Requirements
- Documentation of completed treatment
- No evidence of disease on recent imaging
- Specific site of previous cancer
Code-Specific Risks
- Misuse for active cancer cases
- Omission of specific site details
Coding Notes
- Ensure the documentation specifies the exact site and confirms no active treatment.
Z85.819 - Personal history of malignant neoplasm of unspecified sites of lip, oral cavity, and pharynx
Use when the patient has a history of throat cancer but the specific site is not documented.
Excludes
- Active malignant neoplasm of pharynx (C10-C14)
Clinical Validation Requirements
- Documentation of completed treatment
- No evidence of disease on recent imaging
- Unspecified site of previous cancer
Coding Notes
Ensure documentation supports the use of an unspecified code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Personal history of malignant neoplasm of unspecified sites of lip, oral cavity, and pharynx
Z85.819Personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx
Z85.818Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Throat Cancer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z85.818.
Impact
Clinical: Leads to less specific patient records., Regulatory: May result in coding audits., Financial: Potential for claim denials due to lack of specificity.
Mitigation Strategy
Ensure thorough documentation review., Educate clinicians on the importance of site specificity.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Use active cancer codes (Cxx.x) if the cancer is still being treated.
Impact
Using Z85.819 when the specific site is known but not documented.
Mitigation Strategy
Ensure documentation includes specific site details.
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 Throat Cancer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Throat Cancer
Use these documentation templates to ensure complete and accurate documentation for History of Throat Cancer. These templates include all required elements for proper coding and billing.
Annual Oncology Follow-Up
Specialty: OncologyRequired Elements
- Patient history
- Treatment details
- Current status
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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