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v1.0.0
ICD-10 Guide
ICD-10 CodesC47.1

C47.1

Billable

Malignant neoplasm of peripheral nerves of upper limb, including shoulder

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

Code Description

ICD-10 C47.1 is a billable code used to indicate a diagnosis of malignant neoplasm of peripheral nerves of upper limb, including shoulder.

Key Diagnostic Point:

C47.1 refers to malignant neoplasms that arise from the peripheral nerves in the upper limb, including the shoulder region. These tumors can be classified as soft tissue sarcomas, which are malignant tumors originating from connective tissues, including nerves. The clinical presentation may vary, but symptoms often include pain, swelling, and neurological deficits due to nerve involvement. Diagnosis typically involves imaging studies such as MRI or CT scans, followed by biopsy for histological confirmation. Grading of these tumors is crucial, as it helps determine the aggressiveness of the neoplasm and guides treatment decisions. Multidisciplinary management is essential, involving surgical oncologists, medical oncologists, and radiation oncologists to optimize patient outcomes. Treatment may include surgical resection, chemotherapy, and radiation therapy, depending on the tumor's size, location, and grade. Regular follow-up is necessary to monitor for recurrence or metastasis.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in tumor presentation and symptoms
  • Need for precise documentation of tumor location and characteristics
  • Differentiation from benign tumors and other malignancies
  • Grading and staging complexities

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to specify the exact location of the neoplasm
  • Lack of clarity in treatment plans and multidisciplinary involvement
  • Misclassification of tumor grade

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans must be documented.

Common Clinical Scenarios

Diagnosis and management of soft tissue sarcomas, including surgical interventions and chemotherapy regimens.

Billing Considerations

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

Orthopedic Surgery

Documentation Requirements

Surgical notes detailing the extent of resection and any reconstruction performed.

Common Clinical Scenarios

Surgical management of peripheral nerve tumors, including nerve grafting or reconstruction.

Billing Considerations

Documentation must reflect the functional impact of the tumor and the surgical approach taken.

Coding Guidelines

Inclusion Criteria

Use C47.1 When
  • According to ICD
  • 10 coding guidelines, C47
  • 1 should be used when the documentation specifies a malignant neoplasm of the peripheral nerves in the upper limb
  • It is important to ensure that the diagnosis is confirmed through appropriate imaging and histological examination

Exclusion Criteria

Do NOT use C47.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

38542CPT Code

Excision of soft tissue tumor

Clinical Scenario

Used when a malignant peripheral nerve tumor is surgically excised.

Documentation Requirements

Surgical notes must detail the extent of the excision and any reconstruction performed.

Specialty Considerations

Orthopedic and surgical oncology specialties should ensure comprehensive documentation.

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 granularity of data collection and enhancing the ability to track treatment outcomes and resource utilization for conditions like C47.1.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malignant neoplasms, improving the granularity of data collection and enhancing the ability to track treatment outcomes and resource utilization for conditions like C47.1.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of malignant neoplasms, improving the granularity of data collection and enhancing the ability to track treatment outcomes and resource utilization for conditions like C47.1.

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 is the significance of tumor grading in C47.1?

Tumor grading is crucial as it indicates the aggressiveness of the malignancy and helps guide treatment decisions. Higher-grade tumors may require more aggressive treatment and closer follow-up.