Lymphoma, NOS: Difference between revisions

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{{ICD10 category|Heme/immunology}}{{ICD10 category|Neoplastic}}  
{{ICD10 category|Heme/immunology}}{{ICD10 category|Neoplastic}}{{ICD10 category|Lymphoma}}


== Additional Info ==
== Additional Info ==
*Lymphoma is cancer that begins in infection-fighting cells of the immune system, called lymphocytes. These cells are in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body. When you have lymphoma, lymphocytes change and grow out of control.
Lymphoma is cancer that begins in infection-fighting cells of the immune system, called lymphocytes.
*Non-Hodgkin and Hodgkin lymphoma each affect a different kind of lymphocyte. Every type of lymphoma grows at a different rate and responds differently to treatment.
 
*The body has two main types of lymphocytes that can develop into lymphomas: B-lymphocytes (B-cells) and T-lymphocytes (T-cells).
Includes:  
*There are dozens of subtypes of lymphomas. The World Health Organization (WHO) classifies lymphomas into five major groups, including one for Hodgkin's lymphoma. Within the four groups for NHL there are over 60 specific types of lymphoma. Diagnosis is by examination of a bone marrow or lymph node biopsy. Medical imaging is done to help with cancer staging. The two main categories of lymphomas are:
* other rarer lymphomas for which we don't include specific codes
**Non-Hodgkin (Most people with lymphoma have this type): is a group of blood cancers that includes all types of lymphoma except Hodgkin's lymphomas. T-cell lymphomas account for approximately 15 percent of all NHLs in the United States. 
 
***Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness. Other symptoms may include bone pain, chest pain, or itchiness. Some forms are slow growing while others are fast growing.
'''Excludes'''
***Risk factors include poor immune function, autoimmune diseases, Helicobacter pylori infection, hepatitis C, obesity, and Epstein-Barr virus infection.
* [[Non-Hodgkin's lymphoma]]
***Treatment depends on whether the lymphoma is slow or fast growing and if it is in one area or many areas. Treatments may include chemotherapy, radiation, immunotherapy, targeted therapy, stem cell transplantation, surgery, or watchful waiting. If the blood becomes overly thick due to antibodies, plasmapheresis may be used. Radiation and some chemotherapy, however, increase the risk of other cancers, heart disease or nerve problems over the subsequent decades
* [[Hodgkin's lymphoma (Hodgkin's disease)]]
**Hodgkin: is a type of lymphoma, which is generally believed to result from white blood cells of the lymphocyte kind.
* [[T-cell lymphoma]]
***Symptoms may include fever, night sweats, and weight loss. Often there will be non-painful enlarged lymph nodes in the neck, under the arm, or in the groin. Those affected may feel tired or be itchy.
* SLL- small lymphocytic lymphoma, see [[Chronic lymphocytic leukemia (CLL)|Chronic lymphocytic leukemia]]
***About half of cases of Hodgkin's lymphoma are due to Epstein–Barr virus (EBV). Other risk factors include a family history of the condition and having HIV/AIDS. There are two major types of Hodgkin lymphoma: classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Diagnosis is by finding Hodgkin's cells such as multinucleated Reed–Sternberg cells (RS cells) in lymph nodes.
{{ICD10 Guideline leukemia vs lymphoma}}
***Hodgkin lymphoma may be treated with chemotherapy, radiation therapy, and stem cell transplant
 
{{ICD10 Guideline Cancer}}


== Alternate ICD10s to consider coding instead or in addition ==
== Alternate ICD10s to consider coding instead or in addition ==
 
{{ListICD10Category | categoryName = Lymphoma}}
*[[Hodgkin's lymphoma (Hodgkin's disease)]]
*[[Disorder of lymph nodes and/or lymph vessels, noninfective NOS]]
*[[Non-Hodgkin's lymphoma]]
*[[T-cell lymphoma]]


== Candidate [[Combined ICD10 codes]] ==
== Candidate [[Combined ICD10 codes]] ==


== 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 09:13, 15 February 2025

ICD10 Diagnosis
Dx: Lymphoma, NOS
ICD10 code: C85.8
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
    • C85.8
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Additional Info

Lymphoma is cancer that begins in infection-fighting cells of the immune system, called lymphocytes.

Includes:

  • other rarer lymphomas for which we don't include specific codes

Excludes

Leukemia vs Lymphoma

Any lymphoma may have a leukemic phase where the abnormal clonal cells appear in the circulation. Though this is sometimes referred to as a "leukemia", even by some oncologists, that is technically incorrect and ICD10 considers them to be lymphomas. This applies to essentially ALL so-called B-cell leukemias, which are actually lymphomas. It also applies to "NK-cell leukemia" which is also a lymphoma

As such, the following so-called "leukemias" should be coded as follows:

  • So-called B-cell leukemias describes several different types of lymphoid lymphomas which affect B cells -- and all these should be coded as Lymphoma, NOS
    • "B cell chronic lymphocytic leukemia"
    • "Precursor B cell lymphoblastic leukemia"
    • "Acute Lymphoblastic leukemia, mature B cell type"
    • "B cell prolymphocytic leukemia"
  • So-called "NK-cell leukemia" -- code as T-cell lymphoma
    • Aggressive NK-cell leukemia (also called aggressive NK-cell lymphoma, or ANKL), is a very rare type of NHL. The body makes large numbers of NK cells that are larger than normal. It is grouped with T-cell lymphomas.
    • There is a very rare slow-growing (indolent) type of NK-cell leukemia that has a more favorable prognosis. It is called chronic NK-cell leukemia and is treated like T-cell large granular lymphocytic leukemia.
  • The most common type of lymphoid leukemia is B-cell chronic lymphocytic leukemia.

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

Lymphoma codes:

Data Integrity Checks (automatic list)

none found

Related articles:


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