Oncology & Hematology Coding Alert

Anatomic sites will remain important for choosing colon neoplasm codes.

Under ICD-9, finding the code for colon cancer of overlapping sites takes some detective work. ICD-10 will make the task a little easier.

ICD-9: In some colon cancer cases, physicians can have a hard time determining the cancer's primary site if the cancer has already reached neighboring tissue. Under ICD-9, you use 153.8 (Malignant neoplasm of other specified sites of large intestine) to describe this diagnosis. The code definition may leave you wondering whether this is the most appropriate code for the condition, but an inclusion note with the code clarifies that 153.8 does apply to "Malignant neoplasm of contiguous or overlapping sites of colon whose point of origin cannot be determined."

ICD-10: Under ICD-10, the code set expected to replace ICD-9 on Oct. 1, 2013, the new code that will most closely correspond to 153.8 will be C18.8 (Malignant neoplasm of overlapping sites of colon). As you see from the definition, the code specifically applies to malignancies of overlapping sites of the colon. The ICD-9 and ICD-10 indexes vary a bit, as well, with ICD-9 using the term "contiguous" and ICD-10 using the term "overlapping" to point to the code.

Documentation: Use of the term "overlapping" in the documentation will match ICD-10 terminology most directly. The documentation should describe which specific sites are involved.

Coder tip: Your other colon neoplasm options will have more direct matches between ICD-9 and ICD-10 definitions:

Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.