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ICD-10 Guide
ICD-10 CodesC47.21

C47.21

Billable

Malignant neoplasm of peripheral nerves of right lower limb, including hip

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

Code Description

ICD-10 C47.21 is a billable code used to indicate a diagnosis of malignant neoplasm of peripheral nerves of right lower limb, including hip.

Key Diagnostic Point:

C47.21 refers to malignant neoplasms that arise from the peripheral nerves in the right lower limb, including the hip region. These tumors can be classified as soft tissue sarcomas, which are malignant tumors originating from mesenchymal tissues. The peripheral nerves are critical for motor and sensory functions, and malignancies in this area can lead to significant morbidity. The diagnosis typically involves imaging studies such as MRI or CT scans to assess the extent of the tumor and its relationship to surrounding structures. Histological examination through biopsy is essential for definitive diagnosis and grading of the tumor, which can range from low to high grade based on cellular differentiation and mitotic activity. Multidisciplinary management is crucial, involving surgical resection, chemotherapy, and possibly radiation therapy, depending on the tumor's characteristics and stage. The prognosis varies significantly based on the tumor's grade, size, and the presence of metastasis.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise documentation of tumor location and characteristics.
  • Involves understanding of soft tissue sarcoma grading.
  • Multidisciplinary management necessitates coordination between specialties.
  • Potential for overlapping codes with other neoplasms.

Audit Risk Factors

  • Inadequate documentation of tumor size and grade.
  • Failure to document multidisciplinary treatment approaches.
  • Misclassification of tumor type or location.
  • Inconsistent use of imaging and biopsy results.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and treatment planning for soft tissue sarcomas.

Billing Considerations

Ensure accurate grading and staging are documented for appropriate coding.

Surgery

Documentation Requirements

Operative reports detailing tumor resection and margins.

Common Clinical Scenarios

Surgical intervention for tumor removal.

Billing Considerations

Document the extent of resection and any complications.

Coding Guidelines

Inclusion Criteria

Use C47.21 When
  • According to ICD
  • 10 coding guidelines, C47
  • 21 should be used when the documentation specifies a malignant neoplasm of the peripheral nerves in the right lower limb
  • It is essential to ensure that the diagnosis is confirmed through appropriate imaging and histological examination

Exclusion Criteria

Do NOT use C47.21 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

38542CPT Code

Excision of malignant tumor, soft tissue, including peripheral nerves

Clinical Scenario

Used during surgical resection of the tumor.

Documentation Requirements

Operative report detailing the tumor's size, location, and margins.

Specialty Considerations

Oncology and surgical specialties must coordinate documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding malignant neoplasms, including the ability to specify laterality and tumor characteristics, which enhances data accuracy and improves patient care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding malignant neoplasms, including the ability to specify laterality and tumor characteristics, which enhances data accuracy and improves patient care management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding malignant neoplasms, including the ability to specify laterality and tumor characteristics, which enhances data accuracy and improves patient care management.

Resources

Clinical References

  • •
    American Cancer Society - Soft Tissue Sarcoma

Coding & Billing References

  • •
    American Cancer Society - Soft Tissue Sarcoma

Frequently Asked Questions

What is the significance of grading in soft tissue sarcomas?

Grading indicates the aggressiveness of the tumor and helps guide treatment decisions. Higher-grade tumors are more likely to metastasize and may require more aggressive treatment.