ICD-10 Coding for Neuroblastoma(C47.0, C49.9, C79.51)
Complete ICD-10-CM coding and documentation guide for Neuroblastoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Neuroblastoma
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C47.0 | Malignant neoplasm of peripheral nerves of head, face and neck | Use when neuroblastoma is confirmed in the adrenal gland. |
|
| C49.9 | Malignant neoplasm of connective and soft tissue, unspecified | Use for neuroblastoma in peripheral nerves or autonomic nervous system. |
|
| C79.51 | Secondary malignant neoplasm of bone | Use when neuroblastoma has metastasized to the bone. |
|
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 neuroblastoma
Essential facts and insights about Neuroblastoma
Primary ICD-10-CM Codes for neuroblastoma
Decision Criteria
clinical Criteria
- Confirmed diagnosis of neuroblastoma in the adrenal gland
Applicable To
- Adrenal neuroblastoma
Excludes
- Benign neoplasm of peripheral nerves (D36.1)
Clinical Validation Requirements
- Histopathological confirmation of neuroblastoma
- MYCN amplification status
- INRG stage documentation
Code-Specific Risks
- Misclassification if primary site is not specified
Coding Notes
- Ensure documentation specifies the primary site and laterality.
C49.9 - Malignant neoplasm of connective and soft tissue, unspecified
Use for neuroblastoma in peripheral nerves or autonomic nervous system.
Applicable To
- Peripheral neuroblastoma
Excludes
- Benign neoplasm of connective and soft tissue (D21.9)
Clinical Validation Requirements
- Imaging confirmation of neuroblastoma in non-adrenal sites
- Biopsy results
Coding Notes
Ensure accurate documentation of the tumor site and type.
C79.51 - Secondary malignant neoplasm of bone
Use when neuroblastoma has metastasized to the bone.
Applicable To
- Metastatic neuroblastoma to bone
Excludes
- Primary bone cancer (C41.9)
Clinical Validation Requirements
- mIBG scan confirmation of bone metastases
Coding Notes
Document all metastatic sites clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for antineoplastic chemotherapy
Z51.11Encounter for antineoplastic immunotherapy
Z51.12Bone marrow transplant status
Z94.81Differential 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 Neuroblastoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C47.0.
Impact
Clinical: Inaccurate risk assessment and treatment planning, Regulatory: Non-compliance with oncology documentation standards, Financial: Potential reimbursement issues due to incomplete documentation
Mitigation Strategy
Standardize inclusion of MYCN status in all neuroblastoma reports, Regular audits of oncology documentation
Impact
Reimbursement: Potential claim denial due to lack of specificity, Compliance: Non-compliance with ICD-10 coding guidelines, Data Quality: Inaccurate clinical data affecting treatment decisions
Mitigation Strategy
Ensure documentation includes laterality of the adrenal gland.
Impact
Reimbursement: Incorrect DRG assignment leading to financial loss, Compliance: Violation of coding sequencing rules, Data Quality: Misleading data on treatment encounters
Mitigation Strategy
Sequence Z51.11 before the primary neuroblastoma code.
Impact
Failure to document complete INRG staging can lead to audit issues.
Mitigation Strategy
Implement mandatory staging documentation in EHR templates.
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 Neuroblastoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Neuroblastoma
Use these documentation templates to ensure complete and accurate documentation for Neuroblastoma. These templates include all required elements for proper coding and billing.
Neuroblastoma with chemotherapy
Specialty: OncologyRequired Elements
- Primary site and laterality
- INRG stage
- MYCN status
- Current treatment regimen
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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