Oncology & Hematology Coding Alert

Question: My provider recently had me code for a non-Hodgkin lymphoma that affected the spleen. I can’t find any code specific to the spleen. Should I used the unspecified ICD-10 code C85.90?

South Dakota Subscriber

Answer: For this situation, the code you should use is C85.99 (Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites). The big giveaway that you want to use this code is the specificity of its definition. Remember to be as specific as possible whenever you code.

There are two things that make C85.99 more specific than the code you wanted to use. First, the code you suggested, C85.90 (Non-Hodgkin lymphoma, unspecified, unspecified site) does not indicate the site that you want to code for. In your case, you know that you are coding for the spleen. The spleen is what we call a solid organ. Solid organs are defined as internal organs that have firm tissue consistencies and are not hollow or liquid. The spleen is considered one of these solid organs. This can be looked up using any medical index.

Secondly, the code C85.99 indicates that the site is also extranodal. Extranodal sites are areas outside the lymph nodes. Since the spleen is locatedoutside the lymph nodes, consider this extranodal. Therefore, this condition satisfies the two more specific conditions that validate use of code C85.99.

Don’t forget that C85.99 is one of those codes that require a sixth and seventh character. The sixth character will indicate laterality (right side, left side, bilateral or unspecified), and the seventh character will indicate which encounter this is (initial, subsequent, or sequelae).