Oncology & Hematology Coding Alert

Anatomical location and side should be your focus in 2014.

In ICD-10-CM, you can pick the most specific code for testicular neoplasms only when your physician clearly documents if the affected testis has descended to its scrotal location and if it lies on the right or left side. This two step approach will clear your way to the most specific code.

ICD-9-CM: When reporting testicular neoplasms, you choose between “undescended” code 186.0 (Malignant neoplasm of undescended testis) and “other and unspecified” code 186.9 (Malignant neoplasm of other and unspecified testis).

The code 186.0 applies to both ectopic testis and retained testis. This means the testis is not in its anatomical location in the scrotum. The testis is an abdominal organ during organogenesis (formation and development of organs) and descends to the scrotal location during later fetal development. You report code 186.0 for abdominal, inguinal, prescrotal, or gliding testis.

For neoplasm in a testis that has descended to its scrotal location, you report code 186.9. When your physician does not specify the anatomical location of the testis, you would also submit code 186.9 because it is appropriate for other AND “unspecified testis.”

ICD-10-CM: For services on or after Oct. 1 2014, you will report testicular neoplasms depending upon whether the pathology lies in the right or the left testis. The ICD-9-CM code 186.0 maps to ICD-10-CM codes C62.01 (Malignant neoplasm of undescended right testis) and C62.02 (Malignant neoplasm of undescended left testis) for the right and left sides, respectively. When your physician does not specify the laterality of the undescended testis, you report code C62.00 (Malignant neoplasm of unspecified undescended testis).

Similarly, the ICD-9-CM code 186.9 maps to C62.11 (Malignant neoplasm of descended right testis), C62.12 (Malignant neoplasm of descended left testis), and C62.10 (Malignant neoplasm of unspecified descended testis) for the right, left, and unspecified testis, respectively.

Check the location of testis: ICD-10-CM also gives you three more options to report cases where your physician does not specify the anatomical location of the testis, i.e., you are not sure if it is a descended or undescended testis. In such cases, you choose from the following codes depending upon on which side (right or left) is the testis affected.

• C62.91 (Malignant neoplasm of right testis, unspecified whether descended or undescended)
  
• C62.92 (Malignant neoplasm of left testis, unspecified whether descended or undescended)
  

When your physician neither specifies the location nor the side of the testicular neoplasm, you report code C62.90 (Malignant neoplasm of unspecified testis, unspecified whether descended or undescended) in ICD-10-CM.

ICD-10-CM details: The code descriptor for code 186.9 in ICD-9-CM mentions “other and unspecified” testis. However, ICD-10-CM offers more specific codes. The descriptors clearly specify if the testis is descended or undescended.

What is common in ICD-9-CM and ICD-10-CM: Like in ICD-9-CM, the choice of codes in ICD-10-CM is not guided by the morphology and histology of the primary testicular neoplasm. This means that the codes apply to all primary malignant testicular neoplasms, i.e. germ cell, stromal, mixed, and other tumors (see box).