Per ICD-9-CM Official Guidelines (2015), when the reason for admission is cancer work-up (staging, diagnostic studies) rather than the administration of radiation/chemotherapy, the malignancy is coded first. V58.0 “Radiotherapy” is assigned only as the principal diagnosis when the sole purpose of the encounter is to deliver therapy.

Here, Mary is admitted “for further staging of her cancer”; radiation is performed incidentally. Therefore the principal diagnosis is malignant neoplasm of colon, unspecified (153.9). The principal procedure is the delivery of radiation therapy, Other (92.29). Option A lists exactly these two codes.

B. Places V58.0 first, but admission is not solely for radiotherapy; guidelines prohibit this.

C. V67.09 denotes follow-up after completed treatment; patient still has active malignancy.

D. V10.05 is “personal history of colon cancer,” appropriate only when cancer is no longer present or under treatment.

1. ICD-9-CM Official Guidelines for Coding and Reporting

2015. Section I.C.2.h(3) “Admission for rehabilitation

radiotherapy or chemotherapy” & Section I.C.2.j “Admission/encounter for treatment vs. admission for diagnostic work-up/staging” (pp. 41-43).

2. Lynn Kuehn & Mary Ann Zollars. ICD-9-CM Coding Handbook with Answers

2014. Chapter 2

“Neoplasms

” pp. 56-57.

3. Lou Ann Schraffenberger. Basic ICD-9-CM Coding

2014 ed.

Chapter 4

pp. 137-139 (rules for V58.0

V10.x

V67.x).

(Each source is an AHIMA-published

peer-reviewed textbook or the official coding guideline.)