1. 9 Chapter Nine Neoplasms

2. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Learning Outcomes After completing this chapter, you will be able to: –LO 9.1 Apply general neoplasm coding guidelines. –LO 9.2 Discuss aspects of coding malignant neoplasms. –LO 9.3 Identify terms used to document in situ neoplasms. 9-2

3. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Learning Outcomes (cont.) –LO 9.4 Classify conditions related to benign neoplasms. –LO 9.5 Describe neoplasms of uncertain behavior and neoplasms of unspecified behavior. 9-3

4. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Key Terms benign Bowen’s disease carcinomatosis disseminated malignant neoplasm dysplasia functional activity hemangioma histologic type 9-4 Hodgkin lymphoma in situ International Classification of Diseases for Oncology (ICD-O) Kaposi’s sarcoma leukemia lymphangioma

5. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Key Terms (cont.) lymphoma malignant metastasis morphology multiple myeloma neoplasm Neoplasms Table nevus 9-5 neuroendocrine tumors primary remission secondary topography uncertain behavior

6. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.1 General Neoplasm Coding Guidelines Chapter 2 classification of neoplasms regardless of functional activity Neoplasms are classified by topography Neoplasms Table International Classification of Disease for Oncology (ICD-O) – MORPHOLOGY Chemotherapy, immunotherapy, radiation therapy Complications of neoplasms 9-6

7. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.1 General Neoplasm Coding Guidelines Table 9.1: Sample of Neoplasm Table 9-7

8. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.1 General Neoplasm Coding Guidelines Primary vs. secondary Sequencing History vs. remission Coding guidelines I.C.2. Neoplasms 9-8

9. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.2 Malignant Neoplasms C00-C96 Malignant neoplasms Examples of sites: Mesothelial tissue Hematopoietic tissue Lymphoid tissue Body organs Corresponds to ICD-9-CM categories 140-208 9-9

10. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.2 Malignant Neoplasms C22 Malignant neoplasm of liver and intraheptic bile ducts Instructional notes report additional codes to identify alcohol abuse and dependence C46 Kaposi’s sarcoma When associated with HIV, code B20 prior to C46 C77-C79 Secondary neoplasms Sequencing information found in coding guideline 9-10

11. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.2 Malignant Neoplasms C80 category codes for unspecified sites C80.0 Disseminated malignant neoplasm C80.1 Cancer without specification of site C80.2 Malignant neoplasm associated with transplanted organ 9-11

12. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.2 Malignant Neoplasms C81-C96 Malignant neoplasms of lymphoid, hematopoietic, and related tissues Examples: Hodgkin lymphoma Other non-Hodgkin lymphoma Multiple myeloma Lymphoid leukemia Burkitt lymphoma 9-12

13. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.3 In Situ Neoplasms D00-D09 In situ neoplasms (non-invasive) Examples: Bowen’s disease Cervical intraepithelial neoplasia Ductal carcinoma in situ Prostatic intraepithelial neoplasia Corresponds to ICD-9-CM categories 230-234 9-13

14. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.4 Benign Neoplasms D10-D36 Benign neoplasms (non-cancerous) D3a Benign neuroendocrine tumors Examples of terminology: Hemangioma Nevus Lymphangioma Corresponds to ICD-9-CM categories 209-229 9-14

15. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 9.5 Neoplasms of Uncertain or Unspecified Behavior D37-D49 Neoplasms of Uncertain or Unspecified Behavior D37-D44 and D48 are classified by site Due to specificity of ICD-10-CM, unspecified codes are rarely used – query provider for clarification Corresponds to ICD-9-CM categories 235-239 9-15

16. © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Summary Neoplasms classified by topography Behavior identified as malignant, in situ, benign, uncertain or unspecified Coding for administration of chemotherapy, immunotherapy, and radiation therapy Additional instructions to identify alcohol abuse and dependence, history of tobacco use, tobacco use, and tobacco dependence In-situ neoplasms Benign neoplasms of endocrine glands Uncertain behavior 9-16