The proposed changes to 2012 ICD-9 codes is out; approved by the ICD-9-CM Coordination and Maintenance Committee, the new, revised and invalid codes were published in the Federal Register on May 5, 2011. After the new codes go into effect on October 1 this year, CMS will add ICD-9 codes on an emergency basis as it gears up to switch over the diagnosis coding system to ICD-10.

Expanded ICD-9 diagnosis code sets: As per the changes, from October 1 this year, dermatology coders will be able to report the location of carcinomas and other neoplasms of the skin more accurately. This time they include an expansion of the 173.x (Other malignant neoplasm of skin) series. Each code in that series will get a list of fifth digits that’ll provide specifications on whether the malignant neoplasm is basal cell, squamous cell, or unspecified.

Right now dermatology coders use 173.0 for any non-melanoma malignant neoplasm of the lip. This will become an invalid code once ICD-9 2012 codes go into effect.

When the ICD-9 2012 goes into effect, coders can choose from four options – 173.00, 173.01, 173.02 and 173.09.

Normally, majority of skin cancers are either basal or squamous cell, neither of which are reportable conditions to central cancer registries. Due to the difficulty in distinguishing reportable skin cancers from non-reportable skin cancers, the facilities are transmitting skin cancers to central registries. This puts an additional burden on central registries and also ends up in the transmission of confidential patient information on patients whose information shouldn’t be reported. The expansion of the category of 173 codes will allow for the differentiation of reportable and non-reportable skin cancer.

We’re not sure whether there’ll be expanded skin neoplasm codes when coders update their diagnosis codes in 2013 with the new code set. Presently, ICD-10 is likely to include C44.0-C44.9, a code series that does not have the specificity as the soon-to-go-into-effect ICD-9 2012 codes.

For more 2012 updates, sign up for a good resource like SuperCoder. Such a site comes with an tool to make your task easier and faster!

Testimony Malignant Neoplasm Cancer
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Question by ferdz_c: is thyroidectomy the ONLY way to determine if a papillary lesion / follicular neoplasm is benign or malignant?
My wife recently underwent FNAB for the thyroid gland and the findings were:
1. PAPILLARY LESION
2. FOLLICULAR NEOPLASM.
Suggest thyroidectomy for a definitive diagnosis.
Microscopic Description:
Smears disclose a fairly cellular aspirate composed of cohesive clusters of follicular cells, in attempt to form acini and short papillary fronds. The cells show vesicular nuclei, with focal areas of pleomorphism. The background is hemorrhagic containing thin colloid materials and few mixed leukocytes.

I really would like to know if the it is benign or malignant but is there any other way besides invasive surgery? Thanks a lot in advance for all the answers and help.

Best answer:

Answer by Adumbration
Yes, the entire lesion needs to be looked at and examined for cancer to be ruled out. The FNAB is only a small sampling of the the cells within the lesion. It does not represent the entire thing. It would be like looking at the Mona Lisa by cutting out the eyes. You could say it looks like it’s the Mona Lisa, but can’t be sure unless i look at the whole thing.

Depending on where the lesion is and who the surgeon is, your wife may only have half her thyroid taken out. If it is benign then she is done, if it is malignant they will often take out the other side. Some surgeons will elect to remove it entirely. Depends on several factors.

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