Chapter 2 – Neoplasms (C00–D49)

Question 1

What four behaviors can a tumor be classified as in ICD-10-CM?

Answer 1

Benign, in-situ, malignant, or uncertain behavior

Question 2

True or False: Some benign tumors are found in other chapters, not Chapter 2.

Answer 2

True — for example, prostatic adenomas are in the genitourinary section.

Question 3

How do you code a tumor that overlaps two or more adjacent sites in one organ?

Answer 3

Use the .8 overlapping lesion code, unless a specific combo code is provided.

Question 4

How do you code multiple tumors in the same organ that are not connected?

Answer 4

Code each site separately.

Question 5

How do you code a malignant tumor found in ectopic tissue (abnormal location)?

Answer 5

Code it to the site where it normally would have started, not where it was found.
Example: pancreatic tumor in the stomach → code to pancreas.

Question 6

When using the Neoplasm Table, where do you start?

Answer 6

With the histologic type (e.g., “adenoma”) if known, then confirm the code in the Tabular List.

Question 7

If the visit is for treatment of the primary cancer, what goes first?

Answer 7

The primary malignancy code

Question 8

What if the visit is for chemo, radiation, or immunotherapy?

Answer 8

The Z51.0, Z51.11, or Z51.12 code goes first, then the cancer code.

Question 9

If treating a metastasis, not the original cancer, what do you code first?

Answer 9

The secondary cancer code, then the primary site

Question 10

If anemia is due to the cancer itself, what is coded first?

Answer 10

The cancer, then D63.0

Question 11

If anemia is due to treatment, what is coded first?

Answer 11

The anemia, then the cancer, then T45.1X5- (chemo) or Y84.2 (radiation)

Question 12

If dehydration is the main reason for the visit and cancer is also present, what is coded first?

Answer 12

Dehydration, then the cancer

Question 13

What is coded first when treating a surgical complication of cancer?

Answer 13

The complication

Question 14

What code do you use for a patient with a personal history of primary cancer?

Answer 14

Z85.—

Question 15

If a patient still has metastasis but the primary cancer was removed, what do you code?

Answer 15

The secondary cancer first, then Z85 for personal history of the primary site

Question 16

What goes first if a patient had surgery and is receiving chemo during the same stay?

Answer 16

The cancer code

Question 17

If the visit is only for chemo/radiation/immunotherapy, what goes first?

Answer 17

Z51.0, Z51.11, or Z51.12, then the cancer

Question 18

If a complication develops during chemo/radiation, what goes first?

Answer 18

Still start with the Z51. code, then the complication

Question 19

If a visit is for staging or evaluating the spread of cancer, what goes first?

Answer 19

The cancer code, not the test

Question 20

Should you code symptoms like pain or weight loss if cancer is already diagnosed?

Answer 20

No, not unless it’s the focus of the visit

Question 21

Where are the pain guidelines for cancer-related pain found?

Answer 21

Chapter 6 (G89 category)

Question 22

If a patient has multiple tumors in the same organ, what do you do?

Answer 22

Ask the provider whether they are separate primaries or metastasis

Question 23

When do you use C80.0 for disseminated cancer?

Answer 23

When both primary and secondary sites are unknown

Question 24

When do you use C80.1 for cancer of an unspecified primary site?

Answer 24

→ When the primary site is not identified, but secondary site(s) are known
→ Avoid using in hospitals unless necessary

Question 25

What do you code first when treating a cancer complication like dehydration?

Answer 25

→ The complication, then the cancer → Exception: If the complication is anemia, code cancer first, then anemia

Question 26

If a pathologic fracture is the focus of the visit, what goes first?

Answer 26

→ M84.5- (fracture), then the cancer

Question 27

If the cancer itself is the focus and a fracture is present, what’s the order?

Answer 27

→ Cancer first, then M84.5-

Question 28

True or False: You should code cancer as active if the patient is still being monitored, even if not in treatment.

Answer 28

True

Question 29

What code do you use if cancer is fully treated and gone?

Answer 29

Z85.--- (for primary site) or Z85.89 (for secondary history, if noted)

Question 30

How do you code these cancers if they’re in remission?

Answer 30

Use remission codes from C90–C96 categories

Question 31

What if it’s unclear if the cancer is in remission?

Answer 31

Ask the provider

Question 32

What code do you use if leukemia or myeloma is resolved?

Answer 32

Z85.6 or Z85.79

Question 33

Where do you find codes for follow-ups and aftercare after cancer surgery?

Answer 33

Section I.C.21

Question 34

What codes do you use if a patient had an organ removed to prevent cancer?

Answer 34

Also in Section I.C.21

Question 35

How do you code cancer in a transplanted organ?

Answer 35

→ Use: T86.--- for transplant complication C80.2 for cancer associated with transplant Add the specific cancer code

Question 36

What codes do you use for Breast Implant–Associated Lymphoma?

Answer 36

→ C84.7A = Active → C84.7B = In remission

Question 37

Should you use a surgical complication code for breast implant lymphoma?

Answer 37

No

Question 38

How do you code lymphoid cancer that spreads to an organ like the brain or lung?

Answer 38

→ Use a lymphoma code with extranodal site, NOT a secondary cancer code → Example: C83.398

Question 39

True or False: If a patient has chemo complications, you should code the complication before the cancer.

Answer 39

→ False — for chemo/radiation, Z51. code always goes first