Pathology/Lab Coding Alert
Decipher Lip Diagnosis Codes
Question: When I report malignant neoplasm of the lip, what is the difference between "skin of the lip" in ICD-9 code 173.0 and "lip" in codes 140.0-140.9?
Michigan Subscriber
Answer: Anatomically, the lips extend from the base of the nose to the lower jaw, and laterally, to the naso-labial folds. What we call "lips" in everyday language is just the vermilion border: a small part of the anatomic definition of lips.
Use one of the two unspecified codes when you do not know if the site is upper or lower lip, but you do know that the lesion is from the inner aspect (140.5) or the vermilion border (140.9). Use "other sites" (140.8) for a malignant neoplasm of contiguous or overlapping lip sites with an unknown point of origin.
You should report 173.0 (Malignant neoplasm of skin of lip) for a condition such as malignant melanoma located on the skin outside the vermilion border, such as in the philtrum (the two raised columns of tissue that extend from the nose to the points of the "cupid's bow"). The ICD-9 140.x codes describe malignant neoplasm of other specific locations of the lip:
140.0 -- Upper lip, vermilion border
140.1 -- Lower lip, vermilion border
140.3 -- Upper lip, inner aspect
140.4 -- Lower lip, inner aspect
140.5 -- Lip, unspecified, inner aspect
140.6 -- Commissure of lip
140.8 -- Other sites of lip
140.9 -- Lip, unspecified, vermilion border.
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