When ICD-10 comes into effect, there will be considerable coding and billing changes. An overview of the ICD-10 changes for brain tumor coding makes it evident that there is a direct crossover. Minor differences that are very difficult to locate can result in incorrect coding if you are not alert and updated with all the changes. Here are some of the differences that you can expect in the coming year.
Under ICD-9, while reporting malignant neoplasms of the brain based on the anatomic location of the tumor code 191.x was chosen to be reported. But in ICD-10, while coding for brain neoplasm, the codes will be in identical groups. For instance, ICD-9 codes for the location of the lobe of the tumor were reported using the codes:
- 191.1 with the description Malignant neoplasm of frontal lobe
- 191.2 with the description Malignant neoplasm of temporal lobe
In ICD-10, these codes change to:
- C71.1 with the description Malignant neoplasm of frontal lobe
- C71.2 with the description Malignant neoplasm of temporal lobe
There is also close resemblance of codes in ICD-10 for reporting a tumor in the cerebellum or brain stem with ICD-9.
It is also essential to be specific for all the “overlapping sites” when reporting ICD-10. ICD-10 codes are very specific and that is the main difference that they have with ICD-9. For instance, the ICD-9 code 191.8 has the description “other parts of brain” and the corresponding code in ICD-10, C71.8 has a more specific description “overlapping sites of brain”. So coding becomes very convenient with ICD-10 codes.
For reporting a tumor located in the ventricle, ICD-10 code C71.5 with the description Malignant neoplasm of cerebral ventricle will replace the existing ICD-9code 191.5 for the third and lateral ventricles. On the other hand, for the malignant neoplasm of the fourth cerebral ventricle code C71.7 will be used in ICD-10.
Additionally, when reporting cerebral tumor for a location other than the lobe or ventricles for instance, in the basal ganglia, cerebral cortex, corpus striatum, globus pallidus, hypothalamus and thalamus, the ICD-9 code 191.0 was used. Going forward, ICD-10 code C71.0 with the description Malignant neoplasm of cerebrum, except lobes and ventricles will be used.
When it comes to documentation, since ICD-10 codes are very specific, surgeons need not incorporate any changes in documentation since both are location specific. But it will be a good practice if the tumor is specified as primary tumor. By doing this, it will not only support documentation but at the same time help to simplify the choice that needs to be made for reporting a specific code.