Mary Jo Bowie MS, BS, AAS, RHIA, RHIT

CHAPTER 7 Neoplasms

Neoplasms—Code Range C00-D49 Neoplasms are reported from Chapter 2 of ICD-10-CM. Neoplasms, also known as tumors, are defined as an uncontrolled abnormal growth of cells and are characterized as malignant or benign.

Terminology Morphology—The form and structure of the neoplastic growth Metastasize—The spreading of cells Encapsulated—Surrounded by a capsule Biopsy—Removal of tissue for pathological examination to differentiate between malignant and benign tumors

Malignant Neoplasms Malignant Neoplasms, also known as cancerous growths, are life threatening. Characteristics include: Relatively rapid growth Possible metastasis Interference with normal cell growth Cells are disorderly

Cellular Growth Patterns © Cengage Learning 2014

Common Malignant Neoplasms Liposarcoma Osteogenic sarcoma Leukemia Carcinoma of breast Esophageal adenocarcinoma Fibrosarcoma Adenocarcinoma of the uterus

Benign Neoplasms Benign Neoplasms, also known as nonmalignant tumors, are usually not life threatening. Characteristics include: Relatively slow growth Encapsulation of cells Cells appear similar to tissue of origin Cells do not metastasize

Common Benign Neoplasms Lipoma Osteoma Chondroma Fibroma Meningioma Neuroma Fibroid

ICD-10-CM Behavioral Groupings Found in Neoplasm Table Malignant neoplasms Primary Secondary CA in situ Benign neoplasms Neoplasms of uncertain behavior Neoplasms of unspecified behavior

Locating Neoplasm Codes Step 1—Reference the name of the neoplasm in the Alphabetic Index. Step 2—Follow any cross-reference notes that are present. Step 3—Reference the Neoplasm table by site, then as instructed by the cross-reference note. Step 4—Verify code in the Tabular Index.

Example If coding the phrase “carcinoma of the uterus”, first reference the term carcinoma. In the Index after the main entry of carcinoma the cross-reference note appears that reads: “see also Neoplasm, by site, malignant.” This refers the coder to the Neoplasm Table.

Neoplasm Table The Neoplasm Table is organized alphabetically by anatomical structure. The Table is divided into six columns by the type of behavior of the neoplasm.

ICD-10-CM Official Coding Guidelines for Coding and Reporting Specific Chapter Coding Guidelines for neoplasms include the following: Treatment directed at the malignancy Treatment of secondary site Coding and sequencing of complications Primary malignancy previously excised Admissions/encounters involving chemotherapy, immunotherapy, and radiation therapy

Chapter-Specific Guidelines (cont.) Admission/encounter to determine extent of malignancy Symptoms, signs, and abnormal findings listed in Chapter 18 associated with neoplasms Admission/encounter for pain control/management Malignancy in two or more contiguous sites Disseminated malignant neoplasm, unspecified Malignant neoplasm without specification of site

Chapter-Specific Guidelines (cont.) Sequencing of neoplasm codes Current malignancy versus personal history of malignancy Leukemia in remission versus personal history of leukemia Aftercare following surgery for neoplasm Follow-up care for completed treatment of a malignancy

Chapter-Specific Guidelines (cont.) Prophylactic organ removal for prevention of malignancy Malignant Neoplasm associated with transplanted organ

Coding Practice Select the correct code for: Renal cell Adenocarcinoma of right kidney

Coding Practice Solution Main term to reference in index: Adenocarcinoma Modifying term: Renal cell Code Assignment: C64.1