Look to This Excludes Note for Correct Lymphatic KS Coding
Question: I am confused about how to code for Kaposi sarcoma (KS) of the lymph nodes. Specifically, the oncologist has documented KS of the lymphatic system and the lymph nodes. Do I use C46.1, C46.3, or both? Revenue Cycle Insider Subscriber Answer: According to the American Cancer Society, KS “is a type of cancer that starts in the cells lining your blood vessels or lymph vessels. It most often shows up as purple, red, or brown spots or lumps on your skin or inside your mouth. These are called lesions. KS can also develop in other parts of the body, such as the lymph nodes, lungs, or digestive tract.” ICD-10-CM lists one code specifically for KS of the lymph node, and that is C46.3 (Kaposi’s sarcoma of lymph nodes). However, “Kaposi’s sarcoma of lymphatic(s) NEC” is listed as an inclusion term for C46.1 (Kaposi’s sarcoma of soft tissue). The difference between the two codes is that “lymphatics” refers to the entire lymphatic system, while “lymph nodes” refers to the small filters located throughout the body that remove unwanted material from the lymph fluid that flows throughout the system. So, you would use C46.3 for KS in the lymph nodes only, while you’ll use C46.1 for KS in the entire lymphatic system. But an Excludes2 note under C46.1 notes that you can report KS of the lymph glands and nodes (C46.3) at the same time as KS of the entire lymphatic system (C46.1). In your case, that means you should use both C46.1 and C46.3 for KS of the lymphatic system and the lymph nodes. Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC
