The history code is used whenever there is no further treatment for the primary site and no evidence of disease. There is no set timeframe for this. However if the patient is receiving Tamoxifen or its equivalent then for as long as they are on the drug the cancer is considered active at the primary site. They can receive this drug for up to 10 years after all other treatment. Perhaps this is where your source became confused.
So if the patient is still undergoing radiation, chemo or drugs like tamoxifen then do not code history code, use the active breast cancer code. Even if the drug or radiation is not being administered at this encounter.
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Debra A. Mitchell, MSPH, CPC-H
Coding for History of Breast Cancer
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