General Surgery Coding Alert

Don’t forget additional code.

You’ve had it pretty easy up until now — reporting a malignant tonsil with just one code: 146.0 (Malignant neoplasm of tonsil).

You can forget about easy when ICD-10 goes into effect October 1 this year, because you’ll need to select from four malignant tonsil codes, plus choose a code from a host of additional codes that you must report secondarily.

Learn the Choices:

ICD-9 specifies that 146.0 is for tonsil, faucial, palatine, or not otherwise specified (NOS), and directs you to different codes for lingual or pharyngeal tonsil.

ICD-10 makes the same distinctions — and then some. Instead of one code for the palatine tonsils, you have the following choices:

• C09.0 — Malignant neoplasm of tonsillar fossa

• C09.1 — Malignant neoplasm of tonsillar pillar (anterior) (posterior)

• C09.8 — Malignant neoplasm of overlapping sites of tonsil

• C09.9 — Malignant neoplasm of tonsil, unspecified.

That’s not all: ICD-10 also instructs you to use an additional code from the following list, if applicable, which you should report second:

• alcohol abuse and dependence (F10.-)

• exposure to environmental tobacco smoke (Z77.22) 

• exposure to tobacco smoke in the perinatal period (P96.81)

• history of tobacco use (Z87.891)

• occupational exposure to environmental tobacco smoke (Z57.31)

• tobacco dependence (F17.-)

• tobacco use (Z72.0). 

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