Oncology & Hematology Coding Alert

Question: I need to code a lump in the mouth that hasn’t been biopsied yet. Which code should I use?

Georgia Subscriber

Answer: You should report 784.2 (Swelling mass or lump in head and neck) for a lump in the mouth with no biopsy report.

The ICD-9-CM index doesn’t include an entry for mouth under “lump.” AHA Coding Clinic for ICD-9-CM (First Quarter, 2006) states that when there is no index entry for a specific site under “lump,” you should look under “mass.” The entry “mass, mouth” points to 784.2.

ICD-10-CM: For a mass of the head, the ICD-10-CM index points to R22.0 (Localized swelling, mass and lump, head). Note that there’s a separate code for a neck mass: R22.1 (Localized swelling, mass and lump, neck).