ICD-10 Coding for Lung Cancer with Metastases(C34.90, C79.31)
Complete ICD-10-CM coding and documentation guide for Lung Cancer with Metastases. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lung Cancer with Metastases
C34.0-C34.9Primary Range
Malignant neoplasm of bronchus and lung
Primary code range for lung cancer, specifying the site and laterality of the primary tumor.
Secondary malignant neoplasm of lung
Used when the lung is a site of metastasis from another primary cancer.
Secondary malignant neoplasm of brain
Used for brain metastases originating from a primary lung cancer.
Secondary malignant neoplasm of bone
Used for bone metastases originating from a primary lung cancer.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung | Use when the specific site or laterality of the lung cancer is not documented. |
|
| C79.31 | Secondary malignant neoplasm of brain | Use when brain metastases are confirmed and the primary site is lung. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for lung cancer with mets
Essential facts and insights about Lung Cancer with Metastases
Primary ICD-10-CM Codes for lung cancer with mets
Decision Criteria
clinical Criteria
- Confirmed diagnosis of lung cancer with unspecified site or laterality
Applicable To
- Lung cancer NOS
Excludes
- Benign neoplasm of lung (D14.3)
Clinical Validation Requirements
- Pathology report confirming lung origin
- Imaging studies showing primary lung mass
Code-Specific Risks
- Risk of unspecified coding leading to reimbursement issues
Coding Notes
- Ensure documentation specifies whether the cancer is primary or secondary.
C79.31 - Secondary malignant neoplasm of brain
Use when brain metastases are confirmed and the primary site is lung.
Applicable To
- Brain metastasis
Excludes
- Primary brain neoplasms (C71.-)
Clinical Validation Requirements
- MRI or CT showing brain lesions
- Documentation of metastatic origin from lung
Coding Notes
Ensure proper sequencing based on treatment focus.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of other malignant neoplasm of bronchus and lung
Z85.118Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lung Cancer with Metastases to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C34.90.
Impact
Clinical: Leads to inadequate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims and reduced reimbursement.
Mitigation Strategy
Ensure detailed documentation of cancer sites, Use specific codes whenever possible
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data on cancer prevalence and treatment.
Mitigation Strategy
Confirm the origin of the cancer and use C34.xx for primary lung cancers.
Impact
High risk of audits due to use of unspecified codes without justification.
Mitigation Strategy
Use specific codes and ensure thorough documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Lung Cancer with Metastases, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lung Cancer with Metastases
Use these documentation templates to ensure complete and accurate documentation for Lung Cancer with Metastases. These templates include all required elements for proper coding and billing.
Documenting lung cancer with brain metastases
Specialty: OncologyRequired Elements
- Primary cancer site and histology
- Metastatic sites with imaging confirmation
- Treatment plan and focus
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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