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

2. CHAPTER 7
Neoplasms

3. 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.

4. 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

5. 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

6. Cellular Growth Patterns
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7. Common Malignant Neoplasms
Liposarcoma
Osteogenic sarcoma
Leukemia
Carcinoma of breast
Esophageal adenocarcinoma
Fibrosarcoma
Adenocarcinoma of the uterus

8. 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

9. Common Benign Neoplasms
Lipoma
Osteoma
Chondroma
Fibroma
Meningioma
Neuroma
Fibroid

10. 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

11. 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.

12. 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.

13. 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.

14. 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

15. 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

16. 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

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

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

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