Skin NOS, primary malignancy: Difference between revisions

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{{ICD10 transition status
{{ICD10 transition status
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| OldDxArticle =Skin Cancer
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{{ICD10 category|Skin}}{{ICD10 category|Musculoskeletal/soft tissue}}{{ICD10 category|Neoplastic}}{{ICD10 category|Skin neoplasm}}  
{{ICD10 category|Skin}}{{ICD10 category|Musculoskeletal/soft tissue}}{{ICD10 category|Neoplastic}}{{ICD10 category|Primary malignancy}}{{ICD10 category|Skin neoplasm}}  


== Additional Info ==
== Additional Info ==
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*squamous-cell skin cancer (SCC)
*squamous-cell skin cancer (SCC)
**Squamous-cell skin cancer is more likely to spread. It usually presents as a hard lump with a scaly top but may also form an ulcer.   
**Squamous-cell skin cancer is more likely to spread. It usually presents as a hard lump with a scaly top but may also form an ulcer.   
**melanoma
*merkel cell carcinoma
* a number of less common skin cancers, known as nonmelanoma skin cancer (NMSC)
* a number of less common skin cancers, known as nonmelanoma skin cancer (NMSC)
{{ICD10 Guideline Cancer}}


== Alternate ICD10s to consider coding instead or in addition ==
== Alternate ICD10s to consider coding instead or in addition ==
{{ICD10 category|Skin neoplasm}}
{{ListICD10Category | categoryName = Skin neoplasm}}
*[[Skin, malignant melanoma]]
 
*[[Skin, benign neoplasm]]
*[[Hemangioma or lymphangioma, benign neoplasm, any site]]
*[[Hemangioma or lymphangioma, benign neoplasm, any site]]


== Candidate [[Combined ICD10 codes]] ==
== Candidate [[Combined ICD10 codes]] ==
{{ListICD10Category | categoryName = Metastasis}}
== Related CCI Codes ==


== Related CCI Codes ==
{{Data Integrity Check List}}


== Related Articles ==
== Related Articles ==
{{Related Articles}}
{{Related Articles}}


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{{ICD10 footer}}
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Latest revision as of 08:36, 6 December 2023

ICD10 Diagnosis
Dx: Skin NOS, primary malignancy
ICD10 code: C44
Pre-ICD10 counterpart: none assigned
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: none
Start Date:
Stop Date:
Data Dependencies(Reports/Indicators/Data Elements): No results
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

  • SMW
    • 2019-01-01
    • 2999-12-31
    • C44
  • Cargo


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Additional Info

Excludes:

Includes:

  • basal-cell skin cancer (BCC)
    • Basal-cell cancer grows slowly and can damage the tissue around it but is unlikely to spread to distant areas or result in death. It often appears as a painless raised area of skin, that may be shiny with small blood vessel running over it or may present as a raised area with an ulcer.
  • squamous-cell skin cancer (SCC)
    • Squamous-cell skin cancer is more likely to spread. It usually presents as a hard lump with a scaly top but may also form an ulcer.
  • merkel cell carcinoma
  • a number of less common skin cancers, known as nonmelanoma skin cancer (NMSC)

Using ICD10 Malignancy Codes as a Comorbid Diagnosis

  • Any cancer/malignancy (either a "solid tumor" or a leukemia/lymphoma/bone marrow malignancy/"liquid tumor", i.e. any ICD10 code from C00-C99) can be a comorbid diagnosis --- BUT it's vital to distinguish malignancies in this category based on whether they are believed to be cured or not.
  • If it's still present (or believed to be present), then just include the code for the specific cancer as a comorbid diagnosis.
  • If INSTEAD, it's presumed cured, then in the "bin" of comorbid diagnoses combine the code for the specific cancer with this code: Past history, cancer (any type), believed cured
C00-C99 codes codes:

Metastases

Metastasis codes:

Regarding Presumptive Diagnosis of Malignancy

  • Rarely a presumptive diagnosis is made without any tissue confirmation. This generally occurs with:
    1. risk of obtaining tissue is very high
    2. plan would be palliative regardless
    3. patient would refuse care regardless.
  • Our issue for how to code a presumed malignancy without definitive histopathologic proof is this:
    • If the physicians are going to proceed with a treatment plan without that definitive histopathologic proof --- then code whatever is their best guess about what is present. Example: believed to be lung cancer with a big brain met, and they've decided NOT to do any biopsy but to give palliative radiation therapy, then you'd code lung cancer, and met to brain.
    • If the plan is to obtain a definitive histopathologic diagnosis soon or in the future, then instead code: Neoplasm of uncertain behavior (i.e. not clear if benign or malignant), NOS

"work-up for cancer"

If the cancer has not been confirmed then it should not be coded as cancer. Code relevant test abnormal test results or symptoms.

Testing codes:
Symptom/Sign codes:
Example:   

"I have a patient who comes in with vague respiratory and gi symptoms. They did a chest xray and found a lung mass. They are now working him up for a probable lung ca, with mets to various places. In the old coding I would use ca-nyd. I actually use the ca nyd subcode a lot. I’ve talked to you about this before, because there is no ca nyd in icd10. You told me that you either have cancer or you don’t. For this particular patient I really wouldn’t have anything else I could code in icd10 for him. His symptoms are extremely vague. I don’t really like coding just symptoms, if there isn’t a proper admit diagnosis that fits better anyway. I found a “neoplasm of uncertain behavior (i.e. uncertain if benign or malignant), nos”, but I don’t really like that one. It doesn’t really fit. Is it possible to get something like “admit for workup of malignancy”, or something along those lines?" (Debbie, 12:40, 2018 October 4 (CDT)) How should this be coded? Ttenbergen 12:40, 2018 October 4 (CDT)

Alternate ICD10s to consider coding instead or in addition

Skin neoplasm codes:
Metastasis codes:

Data Integrity Checks (automatic list)

none found

Related articles:


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