Wiki Coding soft tissue mass

Community Wiki

This is a community-maintained wiki post containing the most important information from this thread. You may edit the Wiki once you have been on AAPC for 30 days and have made 5 posts. Learn More
G
Code: C49.9

Code Name: ICD-10 Code for Malignant neoplasm of connective and soft tissue, unspecified

Block: Malignant neoplasm of connective and soft tissue, unspecified

C49

Includes: malignant neoplasm of blood vessel
malignant neoplasm of bursa
malignant neoplasm of cartilage
malignant neoplasm of fascia
malignant neoplasm of fat
malignant neoplasm of ligament, except uterine
malignant neoplasm of lymphatic vessel
malignant neoplasm of muscle
malignant neoplasm of synovia
malignant neoplasm of tendon (sheath)

Excludes1: malignant neoplasm of cartilage (of):articular (C40-C41)
larynx (C32.3)
nose (C30.0)
malignant neoplasm of connective tissue of breast (C50.-)

Excludes2: Kaposi's sarcoma of soft tissue (C46.1)
malignant neoplasm of heart (C38.0)
malignant neoplasm of peripheral nerves and autonomic nervous system (C47.-)
malignant neoplasm of peritoneum (C48.2)
malignant neoplasm of retroperitoneum (C48.0)
malignant neoplasm of uterine ligament (C57.3)
mesothelioma (C45.-)

Details: Malignant neoplasms of mesothelial and soft tissue (C45-C49)

Guidelines: Neoplasms (C00-D49)

Note: Functional activity

All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
Morphology [Histology]
Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
Primary malignant neoplasms overlapping site boundaries
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
Malignant neoplasm of ectopic tissue
Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).

For more details on C49.9 , ICD-10 Code for Malignant neoplasm of connective and soft tissue, unspecified , visit: https://coder.aapc.com/icd-10-codes/

sheffner1

Guest
Messages
19
Best answers
0
Can someone please let me know how you would code a soft tissue mass of any site? We are in disagreement here about which code to use.

Thank you so much
Shannon
 

kevbshields

Guest
Messages
1,101
Location
Louisville, KY
Best answers
0
According to the CPC-H Exam Study Guide, those are coded as excisions by site; what this means is that a patient has a lipoma excised from his/her shoulder, the code would be 23075-6--depending on the depth described in the op report.

I usually go by location (in the op); if it's on a tendon sheath, it should be coded to that site, tendon sheath (if code is available).
 

sheffner1

Guest
Messages
19
Best answers
0
Thank you for the reply, it is very helpful. My question is also the diagnosis code. My coworker wants to code them as a benign neoplasm, but the encoder and ICD-9 book guides me to disorder of skin. Any ideas?
 

kevbshields

Guest
Messages
1,101
Location
Louisville, KY
Best answers
0
I don't trust encoders at all . . .

As for your ICD-9, you'll need the Path report to know the appropriate code assignment in ICD and probably to help you determine that in CPT.

Hope this helps.
 

JHURST

Networker
Local Chapter Officer
Messages
27
Location
Chesapeake, VA
Best answers
0
in pediatric general surgery we see a lot of soft tissue masses and we use 729.9 unless we get a pathology report back with a specific diagnosis.
 

cmartin

Guru
Messages
204
Best answers
0
The secretaries here are always needing codes in order to precert, so no possibility of getting path first for those - hence 729.89 & 729.9
Connie Martin CPC-GENSG
 
Messages
11
Best answers
0
soft tissue mass

When coding excision of a mass, tumor, cyst, what is the magic word in the operative note that leads you to use the musculoskeletal codes? My understanding was, excision must be through the fascia and removed completely otherwise you have to use the integ section. :confused:
 

mbort

True Blue
Messages
2,338
Location
ENGLEWOOD/DENVER
Best answers
0
It really depends on the anatomy. It does not allows have to be through the fascia. Sometimes its subcutaneous, and there is a back code (21930) that has no depth at all. It it very important for the surgeon to document the depth of the excision.
 
Top