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ICD-10 Guide
ICD-10 CodesC49.2

C49.2

Billable

Malignant neoplasm of connective and soft tissue of lower limb, including hip

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

Code Description

ICD-10 C49.2 is a billable code used to indicate a diagnosis of malignant neoplasm of connective and soft tissue of lower limb, including hip.

Key Diagnostic Point:

C49.2 refers to malignant neoplasms originating from connective and soft tissues in the lower limb, including the hip region. These tumors, known as soft tissue sarcomas, can arise from various tissues such as muscle, fat, nerves, and blood vessels. Soft tissue sarcomas are relatively rare, accounting for approximately 1% of all adult cancers. They can be classified into several subtypes, including liposarcoma, leiomyosarcoma, and synovial sarcoma, each with distinct histological features and clinical behaviors. The grading of these tumors is crucial, as it helps determine prognosis and treatment strategies. Grading is typically based on histological examination, assessing factors such as cellularity, pleomorphism, and mitotic activity. Multidisciplinary management is essential for optimal outcomes, involving surgical resection, chemotherapy, and radiation therapy, tailored to the tumor type, grade, and stage. Early diagnosis and intervention are critical, as these tumors can metastasize to distant sites if not treated promptly.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of soft tissue sarcoma subtypes with different coding requirements
  • Need for precise documentation of tumor location and characteristics
  • Grading and staging complexities that influence treatment and coding
  • Potential for metastasis requiring additional codes

Audit Risk Factors

  • Inadequate documentation of tumor type and grade
  • Failure to specify the exact location of the neoplasm
  • Misclassification of benign versus malignant tumors
  • Inconsistent coding of metastatic disease

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, treatment plans, and follow-up notes are essential.

Common Clinical Scenarios

Diagnosis and treatment planning for various soft tissue sarcomas.

Billing Considerations

Ensure accurate grading and staging are documented to guide treatment.

Surgery

Documentation Requirements

Operative reports detailing the extent of resection and margins.

Common Clinical Scenarios

Surgical intervention for tumor resection and reconstruction.

Billing Considerations

Documenting the surgical approach and any complications is critical.

Coding Guidelines

Inclusion Criteria

Use C49.2 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the tumor's location, type, and grade
  • Include any relevant staging information and treatment plans

Exclusion Criteria

Do NOT use C49.2 When
  • Exclude benign tumors and ensure differentiation from other neoplasms

Related ICD-10 Codes

Related CPT Codes

19301CPT Code

Excision, malignant skin lesion

Clinical Scenario

Used when excising a soft tissue sarcoma from the lower limb.

Documentation Requirements

Operative report detailing the excision and margins.

Specialty Considerations

Ensure the surgical approach is documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of soft tissue sarcomas, improving the accuracy of data collection and reimbursement processes. C49.2 provides a clearer understanding of the tumor's location and nature, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of soft tissue sarcomas, improving the accuracy of data collection and reimbursement processes. C49.2 provides a clearer understanding of the tumor's location and nature, facilitating better patient management.

Reimbursement & Billing Impact

reimbursement processes. C49.2 provides a clearer understanding of the tumor's location and nature, facilitating better patient 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 helps determine the aggressiveness of the tumor and guides treatment decisions. Higher-grade tumors are typically more aggressive and may require more intensive treatment.