CCS ICD 10 Chapter 2: Neoplasms (C00-D49) – Flashcards
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Defining neoplasm
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benign, malignant, in situ, uncertain,
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Note
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codes for most benign/malig neops in chapter 2. Some such as prostatic neoplasm may be found in body sys chapter. Determine b,m,is, uncertain 1st
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A primary malig neo overlaps 2 or mor continguous (next to each other) sites classified as overlapping
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malig tumor left breast extends from upper outer quad into axillary tail. C50.812
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female with 2 distinct lesions of RBreast (0.5cm) in upper outer quad and 2nd (1.5) in lower quad, path reports both malig
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C50.411 mal neo of upper-outer quad C50.511 mal neo of lower-outer quad
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Malignant neo of ectopic tissue (unusual) code to site of origin
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ectopic pancreatic malig neo involving stomach. C25.9 pancreas unspec.
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If histological term doc, refer to alpha not neop
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i.e. adenoma not listed in neoplasm table
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Tx directed at malignancy
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If tx directed at mal, Dx1=malignancy
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Tx directed a malignancy EXCEPT
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Encounter solely for admin of chem, imm, rad then Dx1=Z51 (enc for other aftercare/medical care)
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Tx 2ndry site only
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Dx1=2ndry site Dx2: primary site
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Pt w/primary prostate cancer w/metastasis to lungs admitted for wedge resection of mass in right lung.
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C78.1 lung, right Dx2: C61 prostate
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Sequencing complictns: anemia with malignancy
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Tx of anemia in advanced colon cancer. D63.8 Anemia due2 chronic diseas class else C18.9 colon, unspecified
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sequencing compl: anemia assoc w/chem, imm, radi
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enc4 tx of anemia assoc with adv effect of chemo (antineop), etc. & only tx is chemo, anemia 1st D64.8 anemia, chemo C82.18 lymphoma, follicular in alpha T45.1x4 antineoplastic NEC in drug table
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sequenc compl: anemia and radiation
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malig rectal tumor, ext rad 2 shrink tumor. Admit 4 trans to tx anemia related to rad therapy D64.89 anemia unspec. (alpha) C20 rectal tumor (neo table) Y84.2 rad, (ext cause) abnormal rx to rad
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sequen compl: dehyd due to malignancy (only dehy treated).
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Dx1: dehydration Dx2: malignancy
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Sequen compl: surg procd. (tx directed at resolv compl)
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Dx1: complic Dx2
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Primary malignancy previously excised, eradicated, no further tx at site, no further disease at site, code as history
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z85
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Primary site now history and second site treated
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History BC, left radical mast 18 mo, no current tx, bronscopy w/lung biopsy shows metat to right lung Dx1" C78.01 2nd mal neo rt lung Dx2: Z85.3 per his mal neo breast
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Adm/enc involving CIR: surgical removal of neoplasm
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surg removal of 1st/2nd PLUS CIR, Dx1=malign
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Adm/enc involving CIR: enc only for adm of CIR
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Dx1: Z51.11 (antineo chem) Z51.12 (I) Z51.10 (R). If I&C, use both codes Dx2: malign.
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Adm/enc involving CIR: Adm for Rd 2 of rituximab & fludarabine for chronic B cell lymphocytic leukemia
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Dx1: Z51.11 Dx2: Z51.12 Dx3: C91.10 leuk, chronicq
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Adm/enc involving CIR: PT admt for CIR & dev complications
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Dx1: Z51 Dx2: the complication
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Adm/enc involving CIR: adm/enc to determine extent of malig.
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PT w/left lung cancer w/malig pleural effusion admitted 4 paracentesis & initiatn/admin of chemo C34.92 malig lung J91.0 Mal-ple-eff (alpha eff) Z51.11 chem
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Symp, signs, abn findings (C19) assoc w/neo
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SS, AF CANNOT be used to replace prim malignancy, regardless of adm/enc.
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Malig in 2 or more noncontinguous sites
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PT with more than 1 tumor in same organ with different primary and 2nd sites and no know 1 & 2nd. Query provider
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Disseminated defined
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tumor has spread from orig (prim) site of growth to another site, close to/or distant from the prim site. Metastasis is charac of advanced malig but in rare instances can be seen in neos lacking malig morphology.
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Disseminated malig neo, unspecified
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C80.0 disseminated malig neo, unspecified is fo adv metat dis w/no know prim or secon sites are specified
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Patient has had no medical care for many years is send today and diagnosed with carcinmatosis
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C80.0 Should seldom be used
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malig neo w/o specification of site
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C80.1 should only be used when no determine can be made as to prim site - rare usedin IP setting
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Eval of painful hip leads to diagnosis of metastic bone lesion from unknown neo source
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Dx1: 79.51 2nd malig of bone Dx2: C80.1 (prim mal neopl unspecified)
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Seq of neo codes: enc for tx prim malig
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code primary 1st
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Seq of neo codes: enc for tx of secondary malg
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code 2ndary first
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PT has primary colon cancer w/meta to rib and is evaluated for possible excision of portion of rib bone
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C79.51 Bone, rib, 2nd C18.9 colon cancer
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malig neo in preg pt. Use O9A.1, mal neo compl preg, childbirth, puerperium is 1st then malig code
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PT in 2nd tri eval for thyroid malig O9A.112 Preg, compl., neopl. C73
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Enc for compl assoc with neo. When enc for mgmt. of a compl assoc w/neo (i.e. dehy) & TX is only for compl. code comp first (exception is anemia)
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pancreatic cancer for initatn of TPN 4 cancer-related mod protein-calorie nutrn Dx1: E44.0 malnutrition, protein, mod Dx2: C25.9
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compl from surg procedure for tx of neo.
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Code complication first
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pathologic fracture due to a neoplasm. fracture is focus
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Dx1: M84.5 fracture, patho, due to neoplastic dis
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pathologic fracture due to neo BUT tx of neo is dominant
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Dx1: malig code first Dx2: M84.5
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current malig v personal history malig excised but still treated, don't code pers hist Z84
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PT w/ongoing chem after right mastec for BC C50.911 BC (Tx still going on, don't code per hist)
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Leuk, mult myeloma, malg plasma cell neos in remission v pers hist.
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Have categories for "remission" C90. If doc unclear, query provider.
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Aftecare following surgery for neo
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See I.C.21
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F/U care for completed Tx of malig
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see I.C.21
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prophylactic organ removal for prev of malig
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I.C.21
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Malig neop assoc with transplanted organ
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should be coded as a transplant condtion. Dx1: T86 compl of trans organs and tissues Dx 2: C80.2 malig neo assoc with trans organ Dx3: malig
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malignant neoplasm associated with transplanted organ
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C80.2
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Chapter 2 classifies neos primarily by site (topography) i.e.
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malignancy, benign, in situ,
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The neoplasm table should be used to identify the correct topography code.
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In a few cases such as for malig melanoma,
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malignant neo of ectopic tissue
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malig neo of ectopic tiss are 2B coded to site mentioned. i.e. ectopic pancreatic mal neo are coded to pancreas, unspecified
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malignant melanoma
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cancer that develops from pigment-containing cells known as melanocytes. Typically occur in skin (rare in mouth, intestines, eyes). Women: legs. Men: back.
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morphology (histology)
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branch of biology dealing with form of living organisms & relationships between their structures.
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histology
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study of micro anatomy of cells/tissues. Commonly performed by examining cells/tiss under microscope
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Chapter 2: lips, oral, pharynx, respiratory, intrathorac, bone, cartilage, skin, mesothelial,
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soft tiss, breast, genitals, urinary, eye, brain, CNS, thyroid/endocrine glands, ill-defined, uncertain behavior, unspecified behavior
