Oncology & Hematology Coding Alert

And don’t forget to keep your clinical knowledge current.

According to the American Association of Neurological Surgeons (AANS), over 150 different brain tumors have currently been identified (Source: www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Brain-Tumors). That means when your physician diagnoses a patient with a benign brain tumor, you need to know how to narrow down the corresponding ICD-10-CM code quickly and easily.

So, we’ve put together this guide to coding the most common benign brain tumors to help you understand the conditions and rapidly identify the associated code. And we’ve provided some clinical information about the conditions to help you add to your coding understanding.

What Are Benign Brain Tumors?

The AANS explains that, like all tumors, brain tumors can either be benign or malignant. Tumors that have their origins either in the brain or its immediate surroundings are defined as primary tumors, and they can either be benign or malignant. Malignant tumors that originate elsewhere in the body can also travel to the brain where they become metastatic brain tumors.

What Are the Most Common Benign Brain Tumors?

Craniopharyngiomas generally affect children, though they can also affect older adults. Because they have their origins in the pituitary gland and affect hormone production, they often exhibit symptoms similar to pituitary tumors. This makes the two types of tumor clinically difficult to distinguish, though fortunately the two have their own separate ICD-10-CM codes.

How to code them: When your physician documents craniopharyngioma, you should report ICD-10-CM code D35.3 (Benign neoplasm of craniopharyngeal duct).

Meningiomas are the commonest of all the benign brain tumors, according to the AANS. They are named after the meninges, a membrane layer that covers the spinal cord and the brain. These benign tumors often don’t produce symptoms, though when they press on nearby areas, they can cause vision problems, seizures, aphasia, and weakness in the legs and bladder.

How to code them: ICD-10-CM differentiates between meningiomas by anatomic location, so benign tumors on the meninges of the brain are coded to D32.0 (Benign neoplasm of cerebral meninges), whereas you should report benign tumors on the meninges of the spinal cord with D32.1 (Benign neoplasm of spinal meninges). Unspecified benign meningiomas have their own code: D32.9.

Paragangliomas occur near nerve cell bunches, most often in the neck and head where they are also called carotid body tumors. These benign tumors arise from embryonic neuronal cells and sometimes present with symptoms of cranial nerve involvement, most commonly the vagus nerve.

How to code them: For a diagnosis of carotid paraganglioma, you will report code D35.5 (Benign neoplasm of carotid body).

Pineal neoplasms, like meningiomas, create problems when they press on structures surrounding the pineal gland, a structure in the brain that produces the hormone melatonin, which plays an important role in controlling sleep. Depending upon the structures that the tumorous mass compresses, the patient may experience headaches, vomiting, visual disturbances, balance and coordination problems, and hormonal imbalances.

How to code them: When the neurosurgeon diagnoses a benign tumor of the pineal gland, submit ICD-10-CM code D35.4 (Benign neoplasm of pineal gland).

Pituitary adenomas, like craniopharyngiomas, are located in the pituitary gland. They can produce one or more hormones in excess and lead to symptoms like gigantism, Cushing’s syndrome, and decreased sexual function among others. Large pituitary tumors may cause headaches, nausea and vomiting, double vision, and dropping eyelids.