January 9, 2020

Question:
My provider insists on calling some lesions uncertain behavior because he is suspicious of cancer. This is before the pathologist has given a report. Should these be coded as uncertain behavior or unspecified?

Answer:
Uncertain behavior is a diagnosis that should only be assigned by a pathologist (with a path report). Unspecified would be the correct diagnosis for this lesion if no pathological diagnosis of uncertain behavior has been made.

*This response is based on the best information available as of 1/9/20.