Pathology/Lab Coding Alert

Question: The pathology report for an ovary specimen lists M8470/1 for the tumor registry diagnosis. Can we use this for the diagnosis code for billing or should we figure out an ICD-9 code?

Florida Subscriber

Answer: You should not report morphology code M8470/1 on the billing claim form. If the pathology report doesn't list an ICD-9 code or a narrative description that you can use to determine theICD-9 code, you can "translate" the tumor registry morphology code to an ICD-9 code.

Here's how: Use the neoplasm table to locate the most likely ICD-9 code, and then confirm your choice by checking the ICD-9 tabular list. The morphology codes begin with the letter M followed by five digits. The first four digits identify the neoplasm histologic type, such as adenoma or lipoma. A slash and fifth digit follow, indicating the behavior of each neoplasm, corresponding to the ICD-9 neoplasm table as follows:

• 0 benign (ICD-9 sections 210-229)
• 1 unspecified for categories M8000-M8004 (ICD-9 section 239)
• 1 uncertain for categories M8010+ (ICD-9 sections 235-238)
• 2 carcinoma in situ (ICD-9 sections 230-233) (also called intraepithelial, noninfiltrating, or noninvasive)
• 3 primary malignant (ICD-9 sections 140-195, 200-208)
• 6 secondary malignant (ICD-9 sections 196-198).

Zero in: The morphology code on your report represents mucinous cystadenoma, borderline malignancy, according to Appendix A of ICD-9-CM. So you should look at the uncertain behavior code for ovary in the ICD-9 neoplasm, then turn to the tabular list to ensure that you have the right code: 236.2 (Neoplasm of uncertain behavior, ovary).