Q&A Hello, I'm New And Have a Question!

[Clay Armstrong]

I just signed up to this website and hope someone can help me out. I have 2 books but I believe there's a 3rd I need. The 2 that I have are the ICD-O-3 and the Cancer Reporting Handbook 2012. Here's my scenario:
Papillary and follicular carcinoma of the thyroid is coded to:
Morphology_____________________
Topography_____________________

Another scenario is:
Paget's disease with intraductal carcinoma of the breast is coded to:
Morphology______________________
Topography______________________

My question is how do I find the morphology and topography of these questions? I've worked as an ER coder but that was many years ago and I only did it for about 4 months. My wife had received a promotion so we relocated. I tried to use my experience to help find these (morphology and topography) but had no luck. Could someone explain to me which book to use, what to look up, etc. to find the morphology and topography? I think I can figure out a lot of it but need a "push" start.
Thanks in advance.

 

[Alicia Scott]

Welcome Clay to the forum. How exciting to get to do some oncology coding. I had some basic training here while back on oncology so I am thinking off the top of my head here. Give me some time to look in a little more depth for you. Here is what I know:
Cancer status tends to be based on staging. Most of the time they use TNM.
T is Tumor
N is Lymph Nodes
M is Metastasis

Primary Tumor
T1-4 extent and size of the tumor

Reginonal Lymph Nodes
NX regional lymph nodes cannot be evaluated
NO regional lymph nodes are not affected
N1-3 regional lymph nodes are affected (metastasis)

Distant Metastasis
MX Distant metastasis cannot be evaluated
MO No evidence metastasis
M1 Tumor has metastasized

So, if a person has for example squamous cell carcinoma of the cervix with staging T4N1 you would code a secondary code 196.6 Secondary and unspecified malignant neoplasm of lymph nodes, Intrapelvic lymph nodes.

Now, I am thinking is Morphology another term for metastasis and is Topography another word for Tumor size. Keep in mind I have not looked this up but Morph means change and Topography has something to do with maps or mapping I think. Where is it on a map or location.

I will see what I can find out for you though. Regarding another book. I will ask around.

 

[Clay Armstrong]

Thank you Alicia. I recently had an interview for a cancer coding position and these were some of the questions on an assessment I had to take. I'm trying to remember other questions from it to post here. I received my RHIA credential in 2005. I haven't really done much with it since and am trying to "get back into it" but I don't remember much about coding. Also, I contacted the faculty at the university that I attented asking about Oncology coding and they said they never covered it back then and still don't; it's not part of their curriculum. In order for me to get the position I'm applying for I have to do well on the assessment. The only other way I can think of is to take the Cancer Registry Management program AHIMA offers but it's too expensive for me. Thanks for your help!
Clay

 

[Alicia Scott]

Lets start a new thread and I will put in the title Oncology coding. That may get more feedback for you.

 

[Carolyn Heath]

And learning more about Oncology coding as well. Thanks for the new thread, Alicia.

 

[Amy Jeter CPC]

Thanks for the break down. I have worked in an Oncology office for 5 years and never understood that as we don't code those for outpt/physician billing. Glad I can now see how they get the morphology topography

 

[Alicia Scott]

I am getting ready to do a webinar interview by a Ca coding auditor. Hope to cover a lot of very good information. Will keep you informed when I confirm a date with her. I met her in Orlando and she is awesome.