Journal of AHIMA - October 2011

Coding Notes
Coding Neoplasms in ICD-10-CM

By Judy A. Bielby, MBA, RHIA, CPHQ, CCS

ICD-10-CM CODES PROVIDE greater detail than ICD-9-CM codes for reporting neoplasms. In many instances, ICD-10-CM neoplasm codes can provide information on whether a neo- plasm occurred in a right-sided or left-sided body part. ICD-10- CM also provides codes for reporting neoplasm sites with great- er precision. In some instances, ICD-10-CM provides greater detail on the type of neoplasm for malignant neoplasms and for benign and other histologic behaviors. This article compares neoplasm coding in ICD-10-CM and ICD-9-CM and highlights the terminology differences between the two code sets.

Neoplasm Codes in ICD-10-CM

ICD-10-CM shares a number of similarities with ICD-9-CM in terms of neoplasm coding. ICD-10-CM includes a tabular list and an alphabetic index like ICD-9-CM. ICD-10-CM also includes a neoplasm table organized much like the neoplasm table in ICD-9-CM.

Similar to ICD-9-CM, chapter 2 in the ICD-10-CM tabular is titled “Neoplasms,” but the code numbers are different. Chapter 2 in ICD-9-CM contains nearly 960 codes found in categories 140–239, starting with category 140, which contains codes for malignant neoplasm of the lip.

Chapter 2 in ICD-10-CM contains more than 1,540 codes found in categories C00–D49, starting with category C00, which contains codes for malignant neoplasm of the lip.

The table at right compares ICD-9-CM and ICD-10-CM codes for malignant neoplasm of the lip.

The “ICD-10-CM Official Guidelines for Coding and Report-

ing” includes a section on coding guidelines for neoplasms. The ICD-10-CM neoplasm guidelines are very similar to those for ICD-9-CM. However, there are some variations, and coding professionals should obtain and review the guidelines to examine the differences.

Most notably, the ICD-10-CM sequencing guideline for ane-
mia associated with malignancy differs from the ICD-9-CM se-
quencing guideline. The ICD-10-CM guideline states:
When admission/encounter is for management of an anemia
associated with the malignancy, and the treatment is only for ane-
mia, the appropriate code for the malignancy is sequenced as the
principal or first-listed diagnosis followed by code D63.0, Anemia
in neoplastic disease.

In ICD-9-CM, the anemia code would be sequenced as the principal diagnosis followed by the appropriate code for the malignancy.

Because neoplasms can occur anywhere in the body, coding professionals might wonder where to begin refreshing their anatomy and pathophysiology knowledge. The section below examines a few of the changes that will occur between ICD-9- CM and ICD-10-CM neoplasm codes, with a focus on areas in which knowledge of anatomy and pathophysiology will be particularly helpful.