C40-C41
Medium Complexity

Malignant neoplasms of bone and articular cartilage

Primary Specialty: Oncology
Last Updated: 2025-09-09

ICD-10 Codes (7)

7 billable
0 category headers
C41
Billable
Malignant neoplasm of bone and articular cartilage of other and unspecified sites
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C41.0
Billable
Malignant neoplasm of bones of skull and face
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C41.1
Billable
Malignant neoplasm of mandible
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C41.2
Billable
Malignant neoplasm of vertebral column
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C41.3
Billable
Malignant neoplasm of ribs, sternum and clavicle
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C41.4
Billable
Malignant neoplasm of pelvic bones, sacrum and coccyx
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C41.9
Billable
Malignant neoplasm of bone and articular cartilage, unspecified
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Updates & Changes

FY 2026 Updates

Current Year

New Codes (2)

C02.9
Malignant neoplasm of tongue, unspecified, HPV-positive
C10.8
Malignant neoplasm of overlapping sites of oropharynx, HPV-positive

Revised Codes (2)

C01
Malignant neoplasm of base of tongue - updated to include HPV status when known
C09.9
Malignant neoplasm of tonsil, unspecified - enhanced molecular classification

Deleted Codes

No codes deleted in this range for FY 2026

Historical Changes

  • FY 2025: Routine maintenance updates with minor terminology clarifications
  • FY 2024: Enhanced specificity requirements for certain code ranges
  • FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

  • Proposed updates pending review by Coordination and Maintenance Committee
  • Under consideration: Enhanced digital health integration codes

Implementation Guidance

  • Review all FY 2026 updates for C40-C41 codes before implementation
  • Always verify the most current codes in the ICD-10-CM manual
  • Ensure clinical documentation supports the selected diagnosis codes
  • +3 more guidance items...

Range Overview

high priority

The ICD-10 code range C40-C41 represents malignant neoplasms of bone and articular cartilage. This includes primary malignant neoplasms, secondary malignant neoplasms, and malignant neoplasms of unspecified sites. The codes are used to document various types of bone cancers, such as osteosarcoma, Ewing's sarcoma, and chondrosarcoma, among others.

Key Usage Points:

  • C40 codes are used for malignant neoplasms of bone and articular cartilage of limbs.
  • C41 codes are used for malignant neoplasms of bone and articular cartilage of other and unspecified sites.
  • Secondary malignant neoplasms are coded differently from primary malignant neoplasms.
  • The fourth character of the code indicates the specific site of the neoplasm.
  • The fifth character indicates whether the neoplasm is primary, secondary, or unspecified.

Coding Guidelines

When to Use:

  • When a patient is diagnosed with primary bone cancer.
  • When a patient has secondary bone cancer originating from another primary site.
  • When a patient has a malignant neoplasm of the articular cartilage.
  • When the site of the malignant neoplasm is unspecified.

When NOT to Use:

  • When the patient has a benign neoplasm of the bone.
  • When the patient has a non-malignant neoplasm of the articular cartilage.
  • When the patient has a malignant neoplasm of the bone marrow.
  • When the patient has a malignant neoplasm of the connective tissue.

Code Exclusions

Always verify exclusions with the patient's medical record and the latest ICD-10 coding guidelines.

Documentation Requirements

Documentation for C40-C41 codes should clearly specify the type of neoplasm (primary, secondary, unspecified), the site of the neoplasm, and the histological type. If the neoplasm is secondary, the primary site should also be documented.

Clinical Information:

  • Type of neoplasm (primary, secondary, unspecified)
  • Site of the neoplasm
  • Histological type of the neoplasm
  • Primary site (if the neoplasm is secondary)
  • Evidence of metastasis (if applicable)

Supporting Evidence:

  • Pathology reports
  • Imaging studies
  • Surgical reports
  • Clinical notes
Good Documentation Example:

Patient diagnosed with primary osteosarcoma of the right femur. Pathology report confirms diagnosis.

Poor Documentation Example:

Bone cancer.

Common Documentation Errors:

  • Not specifying the type of neoplasm
  • Not specifying the site of the neoplasm
  • Not providing the histological type
  • Not documenting the primary site for secondary neoplasms

Range Statistics

2
Total Codes
7
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:2

Coding Complexity

Medium
Complexity Rating

The complexity of coding C40-C41 codes is medium due to the need to accurately identify the type, site, and histological type of the neoplasm, as well as the primary site for secondary neoplasms. Unspecified sites can also add to the complexity.

Key Factors:
  • Determining the type of neoplasm
  • Identifying the site of the neoplasm
  • Determining the histological type of the neoplasm
  • Identifying the primary site for secondary neoplasms
  • Dealing with unspecified sites

Specialty Focus

C40-C41 codes are primarily used by oncologists, orthopedic surgeons, and pathologists. They are also used by radiologists for imaging studies related to bone cancer.

Primary Specialties:
Oncology
40%
Orthopedic Surgery
30%
Pathology
20%
Radiology
10%
Clinical Scenarios:
  • Patient diagnosed with primary osteosarcoma of the right femur.
  • Patient with breast cancer develops secondary bone cancer.
  • Patient diagnosed with Ewing's sarcoma of the left tibia.
  • Patient with malignant neoplasm of unspecified site.

Resources & References

Resources for C40-C41 codes include the official ICD-10 coding guidelines, clinical reference sources, and educational materials.

Official Guidelines:

  • ICD-10-CM Official Guidelines for Coding and Reporting
  • American Hospital Association Coding Clinic
  • National Center for Health Statistics

Clinical References:

  • American Cancer Society
  • National Cancer Institute

Educational Materials:

  • American Health Information Management Association
  • American Academy of Professional Coders

Frequently Asked Questions

How do I code a secondary malignant neoplasm of bone?

For secondary malignant neoplasms of bone, use a C40-C41 code to specify the site of the secondary neoplasm, and also code the primary site.