Chapter 2 Cancer/Neoplasm
Types of Neoplasm
Malignant – The neoplasm which has the capacity to metastise to
other body parts
Benign – Neoplasms which are not malignant and do not have
tendency to spread in other parts of the body but the possibility
of turning a benign tumor into malignant neoplasm cannot be
neglected
Carcinoma In Situ – Certain neoplasm staying in the same position
and has not changed its size since it was initially identified.
Ectopic tissue – The outward abnormal growth of tissue from the
place of origin not specifically malignant
Contagious Sute – Next to each other
C18.8 – Primary Neoplasm of Overlapping sites of Colon
C26.8 – Primary Neoplasm of Overlapping of Splenic Flexure
The pt present with the malignant neoplasm of left thigh, Dr
scheduled the next visit in OR for the excision of tumour.
C76.52
Skin tumour on upper leg
Tumour of left Femur Bone - C40.22
The pt was diagnosed with brain neoplasm overlapping the
cervical spine, Today he came for the possible intervention of
therapy the Dr advised to lose some weight as it might affect the
metabolism hence deferred the chemotherapy for the next
month.
C71.8
Pt was diagnosed with brain neoplasm overlapping the cervical
spine a month ago, The Pt visits today for the possible
intervention of chemotherapy Dr was happy to see the weight
loss and referred him for therapy session.
Z51.11, C71.8
The pt presents for the metastatic tumour of wrist which is
metastases from the male right chest, Dr referred the pt to
operating room today for wide excision of wrist tumour.
C79.89, C76.1
Wrist swelling due to surgical procedure, Primary neoplasm,
Class 6th 20-10-2024
The pt was diagnosed with the bone neoplasm of iliac 2 years ago
and treatment was directed for iliac crest resection, Today the pt
is diagnosed with malignant secondary neoplasm of right femur
assign the proper ICD 10 cm code.
Secondary neoplasm of right femur, Personal history primary
neoplasm of Iliac
C79.51, Z85.830
Excision – forearm Radius and Ulna, Neoplasm is right radius shaft
If excision is performed a part of the right radius was present
where the tumour is removed
Resection – The Radius is removed
The Pt was scheduled for secondary neoplasm of liver (Operative
intervention includes Excision of the tumour) after 1 hour the
operation was successfully performed and the pt is wide awake
fowling the procedure due to the risk of malignancy the pt is
advised for the chemotherapy and is scheduled tomorrow. History
of Pt condition includes right Renal cell carcinoma.
Liver sec. neoplasm, History of RCC
C78.7, Z85.528
The pt is presented for the chemotherapy as scheduled by the Dr.
following the Excision of the secondary neoplasm of liver, History
of Pt condition includes right Renal cell carcinoma.
Z51.11, history of secondary liver neoplasm, History of RCC
Z51.11, Z85.05, Z85.528
Pt was diagnosed with malignant neoplasm of colon which was
overlapping with splenic flexure and today he is presented for the
implantation of radioactive element after the placement
complication of uncontrolled diarrhia is seen after the placement
for the same what should be the appropriate ICD 10 cm
C18.8, R19.7
The pt is diagnosed with metastatic liver neoplasm
The pt is diagnosed with Cancer – C80.1(rarely)
If the Pt has two or more tumors in the same organ but it is not
clear which is primary or secondary then the provider must be
queried
Dissemniated neoplasm - If the neoplasm is not known whether
it is primary or secondary then the code C80.0 will be used
If primary site is unknown then C80.1
The pt presents with secondary neoplasm of breast, however
upon observation it was seen that the neoplasm hasn’t increased
in size so the decided to observe for additional 6 months,
meanwhile Dr discussed about the chemotherapy results with pt
for tis primary malignancy of wrist and requested to return to
clinic again for chemotherapy. Code the appropriate ICD 10 CM
Excision – Wide excision/Excision 2mm circle 4mm
C79.81, C76.40
Report 1st
A pregnant 3-week woman presents with significant pain after
diagnostic work up a tumour is found in the ovary, hence a brief
operation of biopsy is decided and is done for the same, the
specimen is sent to pathology, Result awaited till the time the
lady was given medicine and is admitted in hospital.
O28.8, Pain in genital organs
Tumour
Biopsy – A sample is taken and sent for lab/Path
Report 2nd
The pathology report came to be malignant neoplasm of right
ovary and it is decided to excise the same in the OR.
O9A.111 , C56.1
Mellissa 63 yr old RHD presented in ER for pain in low back due to
Ground level fall while walking she has a history of pancreatic
cancer and has a relatively low bone density r decided to operate
the L2-L3 spine with fusion and rod
M54.50, W01.0xxa, M85.80, z85.07
Mellissa 63 yr old RHD presented in ER for pain in low back due to
Ground level fall while walking she has a history of pancreatic
cancer and has a relatively low bone density the Xray revealed a
stress fracture in L2-3 hence it is decided to operate the L2-L3
spine with fusion and rod.
S32.029a, s32.039a, W01.0xxa, M85.80, z85.07
ICD NEOPLASM QUESTIONS
1. Give the ICD code for the following:
a. Benign neoplasm of right bronchus and lungs. D14.31
b. Malignant neoplasm of right renal pelvis. C65.1
c. Carcinoma insitu of endometrium. D07.0
d. Acute leukemia. C95.00
e. Malignant neoplasm of lower inner quadrant of left
female breast. C50.312
f. Cancer of epiglottis primary site. C32.1
g. Lung cancer metastatic to the brain. C79.31, C34.90
h. Metastatic carcinoma of spinal cord. C79.49, C80.1
i. Malignant neoplasm of thyroid with hyperthyroidism.
C73, E05.90
2. A 73-year-old white female with a large rapidly growing
malignant tumor in the left breast extending from the upper
outer quadrant into the axillary tail. C50.812
3. A 52-year old white female with two distinct lesions of the
right breast, one (0.5 cm) in the upper outer quadrant and a
second (1.5 cm) in the lower outer quadrant; pathology report
indicates both lesions are malignant. C50.411, C50.511
4. Patient with primary prostate cancer with metastasis to lungs
admitted for wedge resection of mass in right lung. C78.01,
C61
5. A 40-year-old patient is admitted for treatment of anemia in
advanced colon cancer. C18.9, D63.0
6. A 56-year-old Hispanic male with grade II follicular lymphoma
involving multiple lymph node sites referred for blood
transfusion to treat anemia due to chemotherapy. D64.81,
C82.18, T45.1X5A
7. A 55-year-old male with a large malignant rectal tumor has
been receiving external radiation therapy to shrink the tumor
prior to planned surgery. He is admitted today for a blood
transfusion to treat anemia related to radiation therapy.
D64.89, C20, Y84.2
8. History of breast cancer, left radical mastectomy 18 months
ago
with no current treatment; bronchoscopy with lung biopsy
shows metastatic disease in the right lung. C78.01, Z85.3,
Z90.12
9. Patient is admitted for second round of rituximab (a
chemotherapy drug) and fludarabine (an immunotherapy
drug) for his chronic B cell lymphocytic leukemia. Z51.11,
Z51.12, C91.10
10. Patient with left lung cancer with malignant pleural effusion
admitted for thoracentesis and initiation/administration of
chemotherapy. C34.92, J91.0
11. Patient who has had no medical care for many years is seen
today and diagnosed with carcinomatosis. C80.0
12. Evaluation of painful hip leads to diagnosis of a metastatic
bone lesion from an unknown primary neoplasm source.
C79.51, C80.1
13. Patient has primary colon cancer with metastasis to rib and
is evaluated for possible excision of portion of rib bone.
C79.51, C18.9
14. A 30-year-old pregnant female in second trimester is
evaluated for thyroid malignancy. O9A.112, C73, Z3A.00
15. Patient with pancreatic cancer is seen for initiation of Total
Parenteral Nutrition for cancer related moderate
protein-calorie malnutrition. E44.0, C25.9
16. A female admitted with breast cancer with metastasis to the
bone. A mastectomy was performed, and secondary site is
evaluated. C50.919, C79.51
17. A female patient was admitted to rule out metastatic bone
cancer originating from the breast. The breast cancer was
treated with mastectomy and adjunct chemotherapy 3 years
ago. Z85.3, Z90.10
18. A female patient with metastatic bone cancer originating
from the breast that was eradicated 3 years ago, admitted for
pain management. G89.3, C79.51, Z85.3
19. A patient with metastatic bone cancer originating from the
breast that was eradicated 3 years ago, admitted for external
beam radiation to affected bone and implantation of spinal
cord neurostimulator for control of chronic neoplasm related
pain. C79.51, G89.3, Z85.3
20. Female patient is admitted for brachytherapy catheters
inserted for breast cancer of the upper-outer quadrant of the
right breast. C50.4