Tuesday, 28 February 2012

ICD-10: 173.xx Specificity Absent in Translation to C44.xx

You'll shed the basal cell/squamous cell difference in 2013.

You'll hardly have time to get used to differentiating "other" malignant skin neoplasms, for instance basal cell as well as squamous cell carcinomas, using ICD-9 2012 changes when you'll drop the difference again in ICD-10 -- effective Oct. 1, 2013.

In place of distinguishing "other" skin cancer type with the fifth digit, ICD-10 codes will need a fifth digit for certain skin sites based on a difference between right, left, or unspecified.

40 Codes Shrink to 22

You just read in "173 and 041: Get Specific With Fifth Digits for Skin Cancer, E. coli" that ICD-9, 2012 creates 40 novel 173.xx codes.

Based on the existing proposed ICD-10 codes, you'll just have 22 codes to pick from in 2013, as you can see from the following list:

  • C44.0 – (Malignant neoplasm of skin of lip)
  • C44.10 – ( skin of unspecified eyelid, including canthus)
  • C44.11 – (skin of right eyelid, including canthus)
  • C44.12 – ( skin of left eyelid, including canthus)
  • C44.20 – ( skin of unspecified ear and external auricular canal)
  • C44.21 – ( skin of right ear and external auricular canal)
  • C44.22 – (skin of left ear and external auricular canal)
  • C44.30 – ( skin of unspecified part of face)
  • C44.31 – (skin of nose)
  • C44.32 – ( skin of other parts of face)
  • C44.4 – ( skin of scalp and neck)
  • C44.51 – ( anal skin)
  • C44.52 – ( skin of breast)
  • C44.59 – ( other part of trunk)
  • C44.60 – ( skin of unspecified upper limb, including shoulder
  • C44.61 – ( skin of right upper limb, including shoulder
  • C44.62 – ( skin of left upper limb, including shoulder
  • C44.70 – ( skin of unspecified lower limb, including hip
  • C44.71 – ( skin of right lower limb, including hip
  • C44.72 – ( skin of left lower limb, including hip
  • C44.8 – ( overlapping sites of skin
  • C44.9 – ( skin, unspecified.

Change focus: But beginning Oct. 1, 2013, you'll need to be cautious to extract information from the pathology report about the skin site, comprising right or left, for C44.xx.

Clarify Codes for Cancer Registry

One of the reasons for the expanded 173.xx codes is to help find cancers reportable to central cancer registries.

The huge majority of skin cancers are either basal or squamous cell, neither of which are reportable conditions to central cancer registries. The expansion of the codes that come under category 173 in ICD-9 2012 permits facilities to differentiate reportable as well as non-reportable skin cancers, which might diminish the problem of facilities reporting all skin cancers to central registries.

Problem: Under presently proposed ICD-10 codes , you'll no longer be able to use diagnosis codes to differentiate certain skin cancers that aren't reportable to central cancer registries.

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