# Follicular Lymphoma



## mblaine (Nov 15, 2013)

I have an ICD10 question for the group...

The pathology report states:
Malignant, non-Hodgkin lymphoma, B-cell type, Follicular Lymphoma, Grade 2 in a lymph node in the neck


Should I code this as:

C82.11 - Follicular lymphoma grade II, lymph nodes of head, face and neck

OR 

C82.91 - Follicular lymphoma, unspecified, lymph nodes of head, face and neck


I am confused because in the group C82.2 the description has BOTH the grade and the fact that it is unspecified.  But the C82.0, C82.1, C82.3, C82.4 groups do not. 

IF the book had C82.1_ as follicular lymphoma grade II unspecified - then that would be the clear choice.  But the way it is listed is confusing me.  

I am leaning toward C82.11 - but want some opinions, please!


----------



## amyfearn (Nov 16, 2013)

C82.91 wouldn't be correct since it is specified --- b-cell follicular grade II  in neck

i would go with C82.11


----------



## mitchellde (Nov 17, 2013)

mblaine said:


> I have an ICD10 question for the group...
> 
> The pathology report states:
> Malignant, non-Hodgkin lymphoma, B-cell type, Follicular Lymphoma, Grade 2 in a lymph node in the neck
> ...



I am not sure why you want to use an unspecified since the diagnosis is well specified for you and the code C82.11 is a perfect match.  If you look close at the C82.2 category for the grade III type, it can be further specified as a IIIa or IIIb type, the type II is not further broken down this way.  
The clinical information on follicular lymphoma:
A neoplasm of follicle centre b cells which has at least a partial follicular pattern. Follicular lymphomas comprise about 35% of adult non-hodgkin lymphomas in the United States And 22% worldwide. Most patients have widespread disease at diagnosis. Morphologically, follicular lymphomas are classified as grade 1, grade 2, and grade 3, depending on the percentage of the large lymphocytes present. The vast majority of cases (70-95%) express the bcl-2 rearrangement [t(14;18)]. Histological grade correlates with prognosis. Grades 1 and 2 follicular lymphomas are indolent and grade 3 is more aggressive


----------

