Reply To: TNM Path, N, RNP, Site Spec, Edy IDO3 COC

Reply To: TNM Path, N, RNP, Site Spec, Edy IDO3 COC

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#6023
Jim Hofferkamp
Keymaster

This is a tricky one.The edit in question is TNM Path N, Reg Nodes Pos – Ed 7 (COC). But before we get into the edit logic I need to confirm that the coding logic is correct.
Scenario:
2/5/16 Patient diagnosed C508, 8520/32.
2/15/16 Right mastectomy with SLN excision, 3/3 lymph nodes positive.
3/16 to 6/16 Chemotherapy
7/20/16 Completion of right axillary node dissection, 2/12 lymph nodes positive.

My question is whether the right axillary node dissection completed after chemotherapy should be counted in regional nodes positive/Examined. I pulled the rule below from the CS rules for regional nodes positive.

4. Cumulative nodes positive. Record the total number of regional lymph nodes removed and found to be positive by pathologic examination.
a. The number of regional lymph nodes positive is cumulative from all procedures that remove lymph nodes through the completion of surgeries in the first course of treatment.

I’d really like to hear back from some of the forum members on how they interpret the coding rule and if they have a suggestion for the edit.

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