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v1.0.0
ICD-10 Guide
ICD-10 CodesC41.1

C41.1

Billable

Malignant neoplasm of mandible

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

Code Description

ICD-10 C41.1 is a billable code used to indicate a diagnosis of malignant neoplasm of mandible.

Key Diagnostic Point:

Malignant neoplasm of the mandible refers to cancerous tumors that arise from the bone tissue of the mandible, which is the lower jawbone. These tumors can be classified as primary bone sarcomas, such as osteosarcoma, chondrosarcoma, or Ewing's sarcoma, or as metastatic lesions from other primary cancers. Imaging characteristics typically include lytic lesions, periosteal reactions, and possible soft tissue masses, which can be evaluated through X-rays, CT scans, and MRIs. Multidisciplinary management is crucial, involving surgical resection, chemotherapy, and radiation therapy, depending on the tumor type and stage. The prognosis varies significantly based on the histological type, size, and presence of metastasis. Early detection and comprehensive treatment planning are essential for improving patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between primary and metastatic lesions
  • Variety of histological types with different treatment protocols
  • Need for detailed imaging reports to support coding
  • Multidisciplinary approach requiring coordination among specialties

Audit Risk Factors

  • Inadequate documentation of imaging findings
  • Failure to specify the type of malignant neoplasm
  • Lack of multidisciplinary treatment documentation
  • Misclassification of benign lesions as malignant

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of primary bone sarcomas and metastatic lesions.

Billing Considerations

Accurate staging and grading of tumors are critical for treatment planning.

Oral and Maxillofacial Surgery

Documentation Requirements

Surgical reports, imaging studies, and follow-up care documentation.

Common Clinical Scenarios

Surgical resection of mandibular tumors and reconstruction.

Billing Considerations

Documentation must include the extent of resection and any reconstructive procedures performed.

Coding Guidelines

Inclusion Criteria

Use C41.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the tumor type, location, and any associated conditions
  • Include imaging findings and treatment details to support the diagnosis

Exclusion Criteria

Do NOT use C41.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

21085CPT Code

Excision, malignant tumor, mandible

Clinical Scenario

Used during surgical resection of a malignant neoplasm of the mandible.

Documentation Requirements

Surgical notes detailing the extent of resection and pathology results.

Specialty Considerations

Oral and maxillofacial surgeons must document the surgical approach and any reconstructive efforts.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of malignant neoplasms, improving the accuracy of data collection and reimbursement processes. C41.1 provides a clear distinction for coders to identify malignant tumors of the mandible, facilitating better patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malignant neoplasms, improving the accuracy of data collection and reimbursement processes. C41.1 provides a clear distinction for coders to identify malignant tumors of the mandible, facilitating better patient management and research.

Reimbursement & Billing Impact

reimbursement processes. C41.1 provides a clear distinction for coders to identify malignant tumors of the mandible, facilitating better patient management and research.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What imaging studies are necessary for coding C41.1?

Imaging studies such as X-rays, CT scans, and MRIs are essential to document the presence and extent of the malignant neoplasm. Detailed imaging reports should be included in the patient's medical record to support the diagnosis.