Oncology & Hematology Coding Alert

Question: Recently, a patient came in with an aggressive case of ganglioneuroblastoma in her abdomen. I haven’t coded this since ICD-9-CM days, at which point I was using code 171.9. I can’t find the ICD-10-CM equivalent. How should I code this?

Idaho Subscriber

Answer: The appropriate code in this case is C47.4 (Malignant neoplasm of peripheral nerves of abdomen).

Breaking down the word ganglioneuroblastoma will help you understand what steps to take to code correctly. Ganglia are nerves located outside the spine or brain. These nerves belong to the peripheral nervous system. You will find that the C47 (Malignant neoplasms of mesothelial and soft tissue) codes are all specific to the peripheral system and are appropriate for coding ganglioneuroblastoma.

You shouldn’t be suspicious of your relatively short code. At only four characters, C47.4 is one of the few in the C47 category that does not require a fifth character to specify laterality. Unlike neoplasm codes for other areas of the body, such as C47.11 (Malignant neoplasm of peripheral nerves of right upper limb, including shoulder) the nature of the abdomen means that, at four characters, your code gives all the information necessary to identify the malady.

The original code you used does have an ICD-10-CM equivalent. That code is C49.- (Malignant neoplasm of other connective and soft tissue). However, you should not use this code. Although C49 does specify tumors of soft tissue that might include ganglioneuroblastoma in the abdomen, the C47.4 code focuses specifically on the peripheral nervous system as well as the part of the body affected, leaving little room for auditors to kick back your claim.