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ICD-10 Guide
ICD-10 CodesC47.11

C47.11

Billable

Malignant neoplasm of peripheral nerves of right upper limb, including shoulder

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

Code Description

ICD-10 C47.11 is a billable code used to indicate a diagnosis of malignant neoplasm of peripheral nerves of right upper limb, including shoulder.

Key Diagnostic Point:

C47.11 refers to malignant neoplasms affecting the peripheral nerves in the right upper limb, including the shoulder region. These tumors can arise from various types of cells within the peripheral nervous system, including Schwann cells, which are responsible for the myelin sheath surrounding nerves. Soft tissue sarcomas, a category of malignant tumors, can also involve peripheral nerves, leading to complex clinical presentations. Symptoms may include pain, weakness, and sensory changes in the affected limb. Diagnosis typically involves imaging studies such as MRI or CT scans, followed by biopsy for histological confirmation. Treatment often requires a multidisciplinary approach, including surgical resection, radiation therapy, and chemotherapy, depending on the tumor's grade and stage. Grading of these tumors is crucial, as it influences prognosis and treatment strategies. High-grade tumors tend to be more aggressive and may require more intensive treatment regimens. The management of these neoplasms necessitates collaboration among oncologists, surgeons, radiologists, and pain management specialists to optimize patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of histological types of peripheral nerve tumors
  • Need for precise documentation of tumor location and extent
  • Multidisciplinary treatment approaches complicating coding
  • Potential for overlapping symptoms with other conditions

Audit Risk Factors

  • Inadequate documentation of tumor grading
  • Failure to specify the exact location of the tumor
  • Misclassification of tumor type
  • Lack of clarity in treatment plans

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 involving peripheral nerves.

Billing Considerations

Ensure accurate grading and staging of tumors to guide treatment.

Surgery

Documentation Requirements

Operative reports detailing the extent of resection and any nerve involvement.

Common Clinical Scenarios

Surgical intervention for tumor resection in the upper limb.

Billing Considerations

Documenting nerve repair or reconstruction if performed.

Coding Guidelines

Inclusion Criteria

Use C47.11 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the tumor's location, type, and treatment

Exclusion Criteria

Do NOT use C47.11 When
  • Include any relevant staging information and follow the inclusion/exclusion criteria for peripheral nerve tumors

Related ICD-10 Codes

Related CPT Codes

38500CPT Code

Biopsy of lymph nodes

Clinical Scenario

Used when lymph nodes are sampled for staging of the malignancy.

Documentation Requirements

Pathology report and imaging studies must be included.

Specialty Considerations

Oncologists must ensure accurate staging 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 accuracy of data collection and reimbursement processes. C47.11 provides a clear distinction for peripheral nerve tumors, which aids in research and treatment planning.

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. C47.11 provides a clear distinction for peripheral nerve tumors, which aids in research and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. C47.11 provides a clear distinction for peripheral nerve tumors, which aids in research and treatment planning.

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 C47.11?

Tumor grading is crucial as it determines the aggressiveness of the cancer and influences treatment decisions. High-grade tumors may require more aggressive treatment compared to low-grade tumors.