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v1.0.0
ICD-10 Guide
ICD-10 CodesC46.1

C46.1

Billable

Kaposi's sarcoma of soft tissue

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

Code Description

ICD-10 C46.1 is a billable code used to indicate a diagnosis of kaposi's sarcoma of soft tissue.

Key Diagnostic Point:

Kaposi's sarcoma (KS) is a type of cancer that forms in the lining of blood vessels and lymphatic vessels. It is characterized by the development of tumors that can appear as red, purple, or brown patches on the skin, but can also affect internal organs. KS is most commonly associated with immunocompromised states, particularly in individuals with HIV/AIDS. The lesions can be localized or disseminated, and their appearance can vary significantly depending on the stage of the disease. In HIV-positive patients, KS is often a marker of advanced immunosuppression. The pathophysiology of KS involves infection with human herpesvirus 8 (HHV-8), which leads to the proliferation of spindle-shaped cells and angiogenesis. Treatment approaches for KS may include antiretroviral therapy (ART) for HIV management, chemotherapy, radiation therapy, and local therapies such as cryotherapy or laser therapy, depending on the extent and severity of the disease. Early diagnosis and treatment are crucial for improving outcomes in affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Association with HIV/AIDS complicates coding due to the need for additional codes.
  • Variability in presentation and staging of KS can lead to misclassification.
  • Documentation must clearly indicate the relationship between KS and HIV status.
  • Treatment modalities may vary significantly, affecting coding for associated procedures.

Audit Risk Factors

  • Inadequate documentation of HIV status.
  • Failure to document the extent of KS lesions.
  • Misclassification of KS as a benign condition.
  • Inconsistent coding of treatment modalities.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed documentation of tumor characteristics, staging, and treatment plans.

Common Clinical Scenarios

Patients presenting with skin lesions, systemic symptoms, or complications related to KS.

Billing Considerations

Ensure accurate staging and differentiation from other skin lesions.

Infectious Disease

Documentation Requirements

Thorough documentation of HIV status, viral load, and treatment history.

Common Clinical Scenarios

Patients with advanced HIV presenting with opportunistic infections or malignancies.

Billing Considerations

Linkage between HIV treatment and KS management must be clearly documented.

Coding Guidelines

Inclusion Criteria

Use C46.1 When
  • According to ICD
  • 10 guidelines, C46
  • 1 should be used when documenting Kaposi's sarcoma specifically affecting soft tissue
  • Coders must ensure that the patient's HIV status is documented and coded appropriately, as it is a significant factor in the management and prognosis of KS

Exclusion Criteria

Do NOT use C46.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96413CPT Code

Chemotherapy administration

Clinical Scenario

Used for patients receiving chemotherapy for KS.

Documentation Requirements

Document the type of chemotherapy and patient response.

Specialty Considerations

Oncology specialists must ensure accurate coding of chemotherapy regimens.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Kaposi's sarcoma, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the relationship between KS and HIV status.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Kaposi's sarcoma, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the relationship between KS and HIV status.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of documenting the relationship between KS and HIV status.

Resources

Clinical References

  • •
    Kaposi's Sarcoma Research and Education Foundation

Coding & Billing References

  • •
    Kaposi's Sarcoma Research and Education Foundation

Frequently Asked Questions

What is the significance of coding C46.1 in relation to HIV?

C46.1 is significant because it highlights the association between Kaposi's sarcoma and HIV/AIDS, which is crucial for treatment planning and understanding the patient's overall health status.