ICD-10 Coding for Lung Metastasis(C78.00, C78.01)
Complete ICD-10-CM coding and documentation guide for Lung Metastasis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lung Metastasis
C78.00-C78.02Primary Range
Secondary malignant neoplasm of lung
This range is used when the lung is the secondary site of a neoplasm originating from another primary site.
Malignant neoplasm of bronchus and lung
This range is used when the lung is the primary site of cancer, which may have metastasized to other locations.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C78.00 | Secondary malignant neoplasm of unspecified lung | Use when the lung is the secondary site of a neoplasm and the primary site is unspecified. |
|
| C78.01 | Secondary malignant neoplasm of right lung | Use when the right lung is confirmed as the secondary site of a neoplasm. |
|
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 metastasis
Essential facts and insights about Lung Metastasis
Primary ICD-10-CM Codes for lung metastasis
Decision Criteria
clinical Criteria
- Confirmed secondary malignancy in lung via imaging or biopsy
Applicable To
- Metastatic cancer to lung
Excludes
- Primary lung cancer (C34.-)
Clinical Validation Requirements
- CT or MRI confirming metastatic lesions in the lung
- Biopsy indicating secondary malignancy
Code-Specific Risks
- Risk of using unspecified code without confirming primary site
Coding Notes
- Ensure documentation specifies 'metastatic to lung' and includes primary site if known.
C78.01 - Secondary malignant neoplasm of right lung
Use when the right lung is confirmed as the secondary site of a neoplasm.
Applicable To
- Metastatic cancer to right lung
Excludes
- Primary lung cancer (C34.-)
Clinical Validation Requirements
- Imaging showing metastatic lesions in the right lung
- Histological confirmation of secondary malignancy
Coding Notes
Document laterality and primary site clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Metastasis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C78.00.
Impact
Clinical: Impacts treatment planning and follow-up., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials due to incomplete coding.
Mitigation Strategy
Always document laterality for lung sites, Use templates to ensure completeness
Impact
Reimbursement: Incorrect DRG assignment may affect payment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data for cancer registry and research.
Mitigation Strategy
Use C78.00-C78.02 for secondary lung neoplasms.
Impact
Use of unspecified codes like C78.00 without primary site documentation.
Mitigation Strategy
Require documentation of primary site before coding.
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 Metastasis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lung Metastasis
Use these documentation templates to ensure complete and accurate documentation for Lung Metastasis. These templates include all required elements for proper coding and billing.
Metastatic breast cancer to lung
Specialty: OncologyRequired Elements
- Primary cancer site
- Metastatic sites
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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