|Question 1: What does MCC of other site include? Are there any other site other that can be included in this code?
Answer 1: Currently the index includes the sites of genital and buttock to code
C4A.8: Merkel cell carcinoma of other sites. We also include "specified site not elsewhere classified" to this code (C4A.8) in case a site would be documented that is not specifically in the index.
Question 2: How does one code MCC recurrence? Would one have to list both prior
history along with code..for the current lesion ?
Answer 2: If the
recurrence happened after treatment had ended and the patient was in the history phase, then it would be coded using a Chapter 2-Neoplasms code for the new malignancy (even if it is recurring at the site
of the previous malignancy) AND ALSO code 285.821 to show that there was a
Question 3: At what point during treatment of a patient diagnosed with MCC would
we code the patient visit as prior history of MCC?
Answer 3: There is no cut off time. In the past, people have used 5 years as the cut off but that is no longer applicable since treatments are much more effective now. The guidelines for coding malignancy state:
"When a primary malignancy has been previously excised or eradicated
from its site and there is no further treatment directed to that site
and there is no evidence of any existing primary malignancy, a code from
category 285.821: Personal history of malignant neoplasm, should be used to
indicate the former site of the malignancy."
The intent of the history codes (in the cases of history of MCC you
would use 285.821) is to indicate that the condition no longer exists and
is not receiving any treatment, but that has the potential for
recurrence, and therefore may require continued monitoring."