General Surgery Coding Alert

Look for ‘in situ’ direct crosswalk.

Here’s a rarity for you — you’ll have fewer specific codes to choose from in ICD-10 than ICD-9 — for esophageal cancer, that is.

Although many conditions will have a direct crosswalk or an expansion to numerous, more-specific codes when ICD-10 goes into effect on Oct. 1, 2014, the opposite will happen for malignant esophageal cancer.

Curb Redundancies

In fact, you’ll go from eight ICD-9 codes to five ICD-10 codes for malignant esophageal cancer, as follows:

• 150.0 — Malignant neoplasm of cervical esophagus
  
• 150.1 — Malignant neoplasm of thoracic esophagus
  
• 150.2 — Malignant neoplasm of abdominal esophagus
  
• 150.3 — Malignant neoplasm of upper third of esophagus
  
• 150.4 — Malignant neoplasm of middle third of esophagus
  
• 150.5 — Malignant neoplasm of lower third of esophagus
  
• 150.8 — Malignant neoplasm of other specified part of esophagus
  
• 150.9 — Malignant neoplasm of esophagus unspecified site
  
• C15.3 — Malignant neoplasm of upper third of esophagus
  
• C15.4 — Malignant neoplasm of middle third of esophagus
  
• C15.5 — Malignant neoplasm of lower third of esophagus
  
• C15.8 — Malignant neoplasm of overlapping sites of esophagus
  
• C15.9 — Malignant neoplasm of esophagus, unspecified
  

Drop terminology: You can see that ICD-10 doesn’t codes that crosswalk from 150.0-150.2. These codes use the “cervical, thoracic, abdominal” terminology, which is repetitive with the codes that distinguish the upper, middle, and lower third of the esophagus.

That means you’ll have a direct crosswalk from 150.3-150.9 to C15.3-C15.9. Although the code definition varies for C15.8, remember that ICD-9 has a text note following 150.8 indicating that the code includes, “Malignant neoplasm of contiguous or overlapping sites of esophagus whose point of origin cannot be determined.”

Match Carcinoma in situ Codes

You can also expect a direct crosswalk for esophageal carcinoma in situ when you change from ICD-9 to ICD-10. Prepare to change from 230.1 (Carcinoma in situ of esophagus) to D00.1 (Carcinoma in situ of esophagus) when ICD-10 goes into effect next fall.