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ICD-10 Guide
ICD-10 CodesC41.4

C41.4

Billable

Malignant neoplasm of pelvic bones, sacrum and coccyx

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

Code Description

ICD-10 C41.4 is a billable code used to indicate a diagnosis of malignant neoplasm of pelvic bones, sacrum and coccyx.

Key Diagnostic Point:

C41.4 refers to malignant neoplasms located in the pelvic bones, sacrum, and coccyx, which are often classified as bone sarcomas. These tumors can arise from various types of cells within the bone, including osteoblasts, chondrocytes, and fibroblasts. Imaging characteristics typically include lytic lesions, periosteal reactions, and soft tissue masses visible on X-rays, CT scans, or MRIs. The diagnosis often requires a combination of imaging studies and histopathological examination. Multidisciplinary management is crucial, involving orthopedic surgeons, oncologists, radiologists, and pathologists to ensure comprehensive care. Treatment may include surgical resection, chemotherapy, and radiation therapy, depending on the tumor type, stage, and patient health. Early detection and accurate staging are vital for improving outcomes, as these tumors can be aggressive and may metastasize to other areas of the body.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of tumor types (e.g., osteosarcoma, chondrosarcoma)
  • Need for precise imaging interpretation
  • Multidisciplinary approach required for treatment
  • Potential for metastasis complicating coding

Audit Risk Factors

  • Inadequate documentation of imaging findings
  • Failure to specify tumor type
  • Lack of multidisciplinary treatment documentation
  • Misclassification of benign versus malignant lesions

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of bone sarcomas, treatment planning.

Billing Considerations

Ensure accurate staging and tumor type documentation.

Radiology

Documentation Requirements

Comprehensive imaging reports detailing findings and recommendations.

Common Clinical Scenarios

Imaging for suspected bone tumors, follow-up imaging.

Billing Considerations

Clear descriptions of imaging characteristics to support diagnosis.

Coding Guidelines

Inclusion Criteria

Use C41.4 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the tumor type and location
  • Include any relevant staging information and treatment details

Exclusion Criteria

Do NOT use C41.4 When
  • Exclude benign conditions and ensure that the diagnosis is confirmed by imaging and pathology

Related ICD-10 Codes

Related CPT Codes

27447CPT Code

Excision, malignant tumor, pelvis

Clinical Scenario

Used when a patient undergoes surgical excision of a malignant pelvic tumor.

Documentation Requirements

Surgical notes detailing the procedure and tumor characteristics.

Specialty Considerations

Orthopedic oncology specialists should provide detailed operative reports.

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. C41.4 provides a clear designation for pelvic bone malignancies, facilitating better tracking and management of these conditions.

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. C41.4 provides a clear designation for pelvic bone malignancies, facilitating better tracking and management of these conditions.

Reimbursement & Billing Impact

reimbursement processes. C41.4 provides a clear designation for pelvic bone malignancies, facilitating better tracking and management of these conditions.

Resources

Clinical References

  • •
    American Cancer Society - Bone Cancer

Coding & Billing References

  • •
    American Cancer Society - Bone Cancer

Frequently Asked Questions

What imaging studies are most useful for diagnosing C41.4?

X-rays, CT scans, and MRIs are essential for diagnosing malignant neoplasms of the pelvic bones, sacrum, and coccyx, providing critical information on the tumor's size, location, and potential metastasis.