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Home , Cancer, Neoplasm

Volume 3, Issue 12, December 2016 Last Revised: April 2018

Risk Adjustment Coding Academy- Coding Focus

Neoplasms – An Overview

cells are only found in the place where In ICD‐10‐CM, are located in they first formed and have not spread3. chapter 2 of the tabular index, under the following code categories5: Benign and Other Neoplasms  C00‐C96 Malignant neoplasms, Benign neoplasms are tumors that have primary or secondary by site been determined to be noncancerous.  D00‐D09 neoplasms They are localized and have limited  D10‐D36, D3A Benign potential to grow or invade as well as  D37‐D38 Neoplasms uncertain having well differentiated cells. Some behavior, common types of benign neoplasms are and myelodysplastic , and hemangiomas.  D49 Neoplasms unspecified When the behavior of a tumor cannot be behavior The term neoplasm refers to an predicted through , it is called abnormal growth of that occurs a neoplasm of uncertain behavior. These In addition to the tabular index, both when cells divide more than they should are neoplasms which are currently ICD‐9‐CM and ICD‐10‐CM contain a or when cells do not die as they should. benign but have characteristics that neoplasm table that provides a listing of Neoplasms, sometimes referred to as make it possible for the tumor to neoplasms by site, which can then be tumors, are classified mainly by site and become malignant. cross referenced by the aforementioned then further distinguished based upon behavior types. As always, accurate One final category is available for medical record documentation is their behavior. The two main unspecified neoplasm, which is used designations are malignant (or essential for correct diagnosis code when pathology has not yet determined assignment. cancerous) and benign (or non‐ the specific behavior of the neoplasm. cancerous)1.

Resources: Coding Guidance Malignant Neoplasms 1 National Institute (n.d.) NCI There are multiple diagnosis code Dictionary of Cancer Terms. Retrieved Malignant neoplasms are tumors which possibilities for neoplasms, which are November 28, 2016 from cancer.gov are usually irregularly shaped and have based on anatomical site or location and 2 National Cancer Institute (n.d.) poorly differentiated cells that grow or behavior. In ICD‐9‐CM, neoplasm codes Metastatic Cancer. Retrieved November invade other areas and metastasize. were found in chapter 2 of the tabular 28, 2016 from cancer.gov Malignant primary neoplasms refer to index, under the following code 3 Cancer Treatment Centers of America cancerous tumors that originated within categories4: (2015). Cancer in Situ. Retrieved the anatomical site. Malignant secondary  140‐199 Malignant neoplasms, November 28, 2016 from neoplasms refer to cancerous tumors primary or secondary by site that spread to a new site from a primary cancercenter.com  200‐208 Malignant neoplasms site. When this occurs, the primary 4 Hart, A. C., Stegman, M. S., & Ford, B. of lymphatic and hematopoietic cancer is said to be metastatic2. For (2011). ICD‐9‐CM for physicians, volumes tissue example, cancer metastatic to the 1 & 2: 2012 professional: International  209 Neuroendocrine tumors has a primary site of the lung which Classification of , 9th revision,  210‐229 Benign neoplasms has now spread to the secondary Clinical Modification. Eden Prairie, MN:  230‐234 in situ location of the bone. OptumInsight.  235‐238 Neoplasm of uncertain 5 Anita Schmidt, K.K., &, P.W. (2016). ICD‐10‐ Another malignant neoplasm type is an behavior CM Expert for Physicians. Optum360 early stage of cancer known as in situ.  239 Neoplasms unspecified Cancer in situ means that the abnormal

Coverage provided by Amerigroup, Inc. Reference the ICD-10-CM codebook, CMS-HCC Risk Adjustment Model V23, and AHA Coding Clinic for complete code sets and official coding guidance. It is not guaranteed that the information supplied is without defect. Any redistribution or other use is strictly forbidden.

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