By Judy Monestime bio
Watch for changes in neoplasm codes in ICD-10 CM. Chapter 2 of ICD-10 CM, ranging from C00 to D49, includes neoplasm codes which provide greater detail than ICD-9-CM codes for reporting neoplasms.
The chapter includes these blocks
C00-C14 Malignant neoplasms of lip, oral cavity and pharynx
C15-C26 Malignant neoplasms of digestive organs
C30-C39 Malignant neoplasms of respiratory and intrathoracic organs
C40-C41 Malignant neoplasms of bone and articular cartilage
C43-C44 Melanoma and other malignant neoplasms of skin
C45-C40 Malignant neoplasms of mesothelial and soft tissue
C50 Malignant neoplasms of breast
C51-C58 – Malignant neoplasms of female genital organs
C60-C63 Malignant neoplasms of male genital organs
C64-C68 Malignant neoplasms of urinary tract
C69-C72 Malignant neoplasms of eye, brain and other parts of central nervous system
C73-75 Malignant neoplasms of thyroid and other endocrine glands
C7A Malignant neuroendocrine tumors
C7B Secondary neuroendocrine tumors
C76-C80 Malignant neoplasms of ill-defined, other secondary and unspecified sites
C81-C96 Malignant neoplasms lymphoid, hematopoietic and related tissue
D00-D09 In situ neoplasms
D10-D36 Benign neoplasms, except benign neuroendocrine tumors
D3A Benign neoendocrine tumors
D37-D48 Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes
D49 Neoplasms of unspecified behavior
Terminology and sequencing changes
In Chapter 2 of ICD-10 CM, there have been changes from ICD-9 including terminology and sequencing. For example, terminology for neoplasm codes that identify admission status; in ICD-9 the terminology used is “without mention of remission.” However, in ICD-10 the terminology is now “not having achieved remission.”
Another change in the neoplasm chapter is guidelines related to the sequencing of neoplasm codes. The ICD-9-CM Official Guidelines for Coding and Reporting state: “When admission/encounter is for management of an anemia associated with the malignancy, and the treatment is only for anemia, the appropriate anemia code (such as code 285.22, Anemia in neoplastic disease) is designated as the principal diagnosis and is followed by the appropriate code(s) for the malignancy.”
Pay attention to guideline
Pay careful attention to coding guideline I.C. 2.c.1, anemia associated with malignancy. The ICD-10-CM Official Guidelines for Coding and Reporting state: “When admission/encounter is for management of an anemia associated with the malignancy, and the treatment is only for anemia, the appropriate code for the malignancy is sequenced as the principal or first-listed diagnosis followed by the appropriate code for the anemia (such as code D63.0, Anemia in neoplastic disease).”
When the admission is for management of anemia associated with malignancy and the treatment is only for the anemia, in ICD-9-CM, coders sequence the anemia first. Under ICD-10, the malignancy code is sequenced first followed by the anemia code.
Let’s practice! How do you code the following?
Female patient comes in today due to severe anemia due to right breast carcinoma of the central portion.
C50.111 Malignant neoplasm of central portion of right female breast
D63.0 Anemia in neoplastic disease
Rationale: The ICD-10-CM Official Guidelines for Coding and Reporting instruct coders to sequence the malignancy code as the principal diagnosis followed by the appropriate code for the anemia (such as code D63.0, Anemia in neoplastic disease). So in this example code C50.111 (Malignant neoplasm of central portion of right female breast) would be the principal diagnosis followed by code D63.0 (Anemia in neoplastic disease).
Judy Monestime, MBA, CDIP, CPC, is an AHIMA-approved ICD-10-CM/PCS trainer.
