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ICD-10 Guide
ICD-10 CodesC13.8

C13.8

Billable

Malignant neoplasm of overlapping sites of hypopharynx

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

Code Description

ICD-10 C13.8 is a billable code used to indicate a diagnosis of malignant neoplasm of overlapping sites of hypopharynx.

Key Diagnostic Point:

C13.8 refers to malignant neoplasms that occur in overlapping sites of the hypopharynx, which is the part of the throat located behind the larynx and above the esophagus. This code encompasses cancers that may not be confined to a single anatomical site within the hypopharynx, making it crucial for accurate coding and treatment planning. The hypopharynx is adjacent to the oropharynx and larynx, and malignancies in this area can present with symptoms such as dysphagia, hoarseness, and throat pain. The etiology of hypopharyngeal cancers often includes risk factors such as tobacco use, alcohol consumption, and human papillomavirus (HPV) infection, particularly HPV type 16, which has been increasingly recognized in oropharyngeal cancers. Treatment typically involves a multidisciplinary approach, including surgery, radiation therapy, and chemotherapy, depending on the stage and location of the tumor. Radiation therapy is a common treatment modality, especially for patients who are not surgical candidates or for those with advanced disease. Accurate coding of C13.8 is essential for appropriate reimbursement and tracking of cancer epidemiology.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Overlap of anatomical sites complicates precise coding.
  • Variability in clinical presentation and staging.
  • Need for detailed documentation of HPV status.
  • Potential for multiple treatment modalities affecting coding.

Audit Risk Factors

  • Inadequate documentation of tumor location and extent.
  • Failure to document HPV status.
  • Misclassification of overlapping sites.
  • Inconsistent treatment documentation.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, treatment plans, and follow-up notes.

Common Clinical Scenarios

Patients presenting with dysphagia and weight loss, diagnosed via biopsy.

Billing Considerations

Ensure accurate staging and documentation of treatment response.

Otolaryngology

Documentation Requirements

Surgical notes, imaging studies, and preoperative evaluations.

Common Clinical Scenarios

Patients undergoing laryngectomy or radiation therapy for hypopharyngeal cancer.

Billing Considerations

Document the extent of surgical resection and any complications.

Coding Guidelines

Inclusion Criteria

Use C13.8 When
  • According to ICD
  • 10 coding guidelines, C13
  • 8 should be used when the neoplasm is confirmed as malignant and overlaps multiple sites within the hypopharynx
  • Coders should ensure that documentation supports the diagnosis and that any relevant staging information is included

Exclusion Criteria

Do NOT use C13.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

31575CPT Code

Laryngoscopy, flexible

Clinical Scenario

Used for diagnosis and staging of hypopharyngeal cancer.

Documentation Requirements

Document findings and any biopsies performed.

Specialty Considerations

Otolaryngologists should ensure thorough documentation of the procedure.

77401CPT Code

Radiation treatment delivery

Clinical Scenario

Used for patients receiving radiation therapy for hypopharyngeal cancer.

Documentation Requirements

Document treatment plans and patient response.

Specialty Considerations

Oncologists should provide detailed treatment records.

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 data accuracy and treatment tracking. C13.8 provides a distinct code for hypopharyngeal cancers that may not fit neatly into other categories, enhancing the granularity of cancer registries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of overlapping sites, improving data accuracy and treatment tracking. C13.8 provides a distinct code for hypopharyngeal cancers that may not fit neatly into other categories, enhancing the granularity of cancer registries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of overlapping sites, improving data accuracy and treatment tracking. C13.8 provides a distinct code for hypopharyngeal cancers that may not fit neatly into other categories, enhancing the granularity of cancer registries.

Resources

Clinical References

  • •
    American Cancer Society - Head and Neck Cancers
  • •
    National Cancer Institute - Hypopharyngeal Cancer

Coding & Billing References

  • •
    American Cancer Society - Head and Neck Cancers
  • •
    National Cancer Institute - Hypopharyngeal Cancer

Frequently Asked Questions

What is the significance of HPV status in hypopharyngeal cancers?

HPV status is significant as it can influence treatment decisions and prognosis. HPV-positive tumors are often associated with better outcomes compared to HPV-negative tumors.

How do overlapping sites affect treatment planning?

Overlapping sites can complicate treatment planning as they may require a combination of surgical, radiation, and chemotherapy approaches to address all affected areas effectively.