ICD-10 Coding for Small Cell Lung Cancer(C34.90, C34.91)
Complete ICD-10-CM coding and documentation guide for Small Cell Lung Cancer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Small Cell Lung Cancer
C34.90-C34.92Primary Range
Malignant neoplasm of bronchus and lung, unspecified
Primary range for coding small cell lung cancer with unspecified laterality.
Secondary malignant neoplasm of lung
Used for coding metastatic sites when lung cancer spreads to another lung.
Secondary malignant neoplasm of brain
Used for coding brain metastasis from 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 and laterality of the lung cancer are not documented. |
|
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung | Use when the cancer is confirmed in the right 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 small cell lung cancer
Essential facts and insights about Small Cell Lung Cancer
Primary ICD-10-CM Codes for small cell lung cancer
Decision Criteria
documentation Criteria
- Document specific site and laterality of the tumor.
clinical Criteria
- Confirm diagnosis with biopsy and imaging.
Applicable To
- Unspecified lung cancer
Excludes
- Benign neoplasm of lung
Clinical Validation Requirements
- Biopsy confirming small cell carcinoma
- Imaging showing lung mass
Code-Specific Risks
- May lead to unspecified coding if laterality is known but not documented.
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
C34.91 - Malignant neoplasm of unspecified part of right bronchus or lung
Use when the cancer is confirmed in the right lung.
Applicable To
- Right lung cancer
Excludes
- Benign neoplasm of lung
Clinical Validation Requirements
- Biopsy confirming small cell carcinoma
- Imaging showing right lung mass
Coding Notes
Ensure right laterality is documented.
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 Small Cell Lung Cancer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C34.90.
Impact
Clinical: Incomplete clinical picture., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement for metastatic treatment.
Mitigation Strategy
Ensure all imaging and pathology reports are reviewed., Include metastatic sites in clinical documentation.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases the accuracy of health records.
Mitigation Strategy
Document and code the specific laterality of the tumor.
Impact
High risk of audits due to unspecified codes when specificity is available.
Mitigation Strategy
Ensure all documentation includes specific laterality and metastatic sites.
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 Small Cell Lung Cancer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Small Cell Lung Cancer
Use these documentation templates to ensure complete and accurate documentation for Small Cell Lung Cancer. These templates include all required elements for proper coding and billing.
Initial Diagnosis of SCLC
Specialty: OncologyRequired Elements
- Histologic confirmation
- Tumor laterality
- Metastatic sites
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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