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Learning to code, for me, has been as much an exercise in coding protocols as it has been changing how I think. Due to my engineering background I'm very literal so, at times this has tripped me up although I believe it should also help. Your question regarding remission or history is an example. Re-read the definition for each and see, remission means it is not totally cured, but in the process. History (Z codes) are for conditions that no longer exist. But if the MR states "The patient has a history of DM", that means they currently have it, not that you use the Z codes.

I believe your Neoplasm quiz is different than mine, but the Alpha has D18.09 for Specified site NEC. That is a start, but then, checking the Neoplasm table, "retina" (a specified site and much more informative!) and you know it was not specified as malignant primary or secondary, Ca in situ, benign, or that pathology was done and they are uncertain, all that remains is the behavior was "unspecified".  D49.81  Then check Tabular and see this fits and is much more descriptive than D18.09.

So the learning process takes time and practice. Your questions appear to be similar to mine when I started. Re-read the coding guidelines and you may find they are more orderly than you imagine. Stick with the order, or rules, and you may see you are training your thinking processes to match up with that needed to code correctly.  If I can make it to MOD IV, you can too.

Hi Heidi! D18.09 is the correct code, that is a text error. I also got that one wrong and asked my instructor about it.

Another tip from my instructor is that "the alpha will give you the code you need and does not instruct you to go to the Table of Neoplasms so you don't need to look there and not all neoplasm codes are listed in Table of Neoplasms."

Also, I purchased Taber's Cyclopedic Medical Dictionary from Amazon. It's around $40.00. This is a lifesaver when wanting to quickly look up a medical word that you do not know.

Hope that helps,

Brandy Chadwick 

Thanks Brandy!!  After I posted I thought "What if there was an error in the answer key" and heavens knows I don't want to pass on bad habits. I remember quite a few answer key errors, along with my own errors!

Document why you feel you are right, send that in and the instructor will set us all straight :-)

Thanks for the tip on the Medical Dictionary - Are you allowed to take it for your  exam ?

Hi Heidi,

I understand what you're saying... Not too long ago I was exactly where you're at... learning about Neoplasms and all.  I'm currently at the end of Coding - Module 1 - Section 18 with my final exam being the last thing to complete.  My best advice to you is to send your instructor an email when you want/need a clearer understanding on anything.  Even when you get a response and for some reason you still aren't getting it, try to be really clear on what you're not understanding and the instructor will try to help get you through.  It's always best to go directly to the source (the instructor).  Best of Luck to you

It is so encouraging to hear from other students, what a blessing, thank you everyone for your kindness and help!  

Brandy I just ordered the book, thank you for that suggestion.  

Hello!

I just want to say that the Neoplasm Coding Guidelines (located in the front of the book on pp 8 and 9) address many of these concerns.  Specifically, please refer to page 9, m. Current malignancy versus personal history of malignancy.  This paragraph explains in detail how to determine if a malignancy should be coded as current or as a personal history.

Kristi

Hi, Heidi!

If you are still having some confusion about how to code the neoplasms in this section send me an email and I'll walk you through the process.

Debby