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ICD-10 Guide
ICD-10 CodesC11.8

C11.8

Billable

Malignant neoplasm of overlapping sites of nasopharynx

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 C11.8 is a billable code used to indicate a diagnosis of malignant neoplasm of overlapping sites of nasopharynx.

Key Diagnostic Point:

C11.8 refers to malignant neoplasms that occur in overlapping sites of the nasopharynx, which is the upper part of the throat behind the nose. This code encompasses various types of cancers that may not be distinctly classified into specific sites within the nasopharynx. These tumors can arise from different cell types, including squamous cells, and may be associated with risk factors such as human papillomavirus (HPV) infection. HPV-positive oropharyngeal cancers have been increasingly recognized, particularly in younger populations, and are often linked to better prognoses compared to HPV-negative cases. Treatment typically involves a combination of radiation therapy and chemotherapy, especially for advanced stages. Accurate coding is crucial for appropriate treatment planning and reimbursement, as well as for tracking cancer epidemiology and outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation between overlapping sites and specific sites of the nasopharynx.
  • Need for precise documentation of tumor type and HPV status.
  • Variability in treatment protocols based on cancer staging.
  • Potential for multiple malignancies in the head and neck region.

Audit Risk Factors

  • Inadequate documentation of tumor location and type.
  • Failure to document HPV status.
  • Misclassification of overlapping sites.
  • Inconsistent staging information.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and treatment planning for nasopharyngeal cancers, including staging and HPV testing.

Billing Considerations

Ensure accurate coding of overlapping sites and any associated conditions.

Radiation Oncology

Documentation Requirements

Radiation treatment plans, dosimetry reports, and follow-up assessments.

Common Clinical Scenarios

Patients receiving radiation therapy for nasopharyngeal cancer.

Billing Considerations

Document the specific radiation techniques used and any side effects experienced.

Coding Guidelines

Inclusion Criteria

Use C11.8 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the malignancy's site, type, and any relevant HPV status
  • Include staging information when available

Exclusion Criteria

Do NOT use C11.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

77263CPT Code

Radiation treatment delivery, complex

Clinical Scenario

Used for patients receiving radiation therapy for nasopharyngeal cancer.

Documentation Requirements

Radiation treatment plans and patient consent forms.

Specialty Considerations

Oncology specialists should ensure accurate documentation of treatment plans.

30140CPT Code

Biopsy of nasopharynx

Clinical Scenario

Performed to confirm diagnosis of malignant neoplasm.

Documentation Requirements

Pathology reports and imaging studies.

Specialty Considerations

Ensure clear documentation of biopsy results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of overlapping sites, improving the accuracy of cancer registries and treatment planning. C11.8 provides a distinct code for overlapping sites that were previously lumped together, enhancing the granularity of cancer data.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of overlapping sites, improving the accuracy of cancer registries and treatment planning. C11.8 provides a distinct code for overlapping sites that were previously lumped together, enhancing the granularity of cancer data.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of overlapping sites, improving the accuracy of cancer registries and treatment planning. C11.8 provides a distinct code for overlapping sites that were previously lumped together, enhancing the granularity of cancer data.

Resources

Clinical References

  • •
    American Cancer Society - Nasopharyngeal Cancer
  • •
    National Cancer Institute - HPV and Cancer

Coding & Billing References

  • •
    American Cancer Society - Nasopharyngeal Cancer
  • •
    National Cancer Institute - HPV and Cancer

Frequently Asked Questions

What is the significance of HPV status in nasopharyngeal cancer?

HPV status can influence treatment decisions and prognosis. HPV-positive tumors are often associated with a better response to treatment and improved survival rates compared to HPV-negative tumors.

How do overlapping sites affect treatment planning?

Overlapping sites may complicate treatment planning as they can involve multiple anatomical structures, requiring a multidisciplinary approach to ensure comprehensive care.