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ICD-10 Guide
ICD-10 CodesC72.31

C72.31

Billable

Malignant neoplasm of right optic nerve

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

Code Description

ICD-10 C72.31 is a billable code used to indicate a diagnosis of malignant neoplasm of right optic nerve.

Key Diagnostic Point:

C72.31 refers to a malignant neoplasm located in the right optic nerve, which is a crucial component of the central nervous system (CNS). This type of tumor can arise from glial cells, meningeal cells, or other supporting structures within the optic nerve. Symptoms may include vision loss, visual field defects, and other neurological deficits depending on the tumor's size and location. Imaging studies, particularly MRI, are essential for diagnosis, allowing for visualization of the tumor's extent and its effect on surrounding structures. Molecular markers, such as genetic mutations or specific protein expressions, may also be evaluated to guide treatment decisions and prognostication. Treatment typically involves a multidisciplinary approach, including surgical resection, radiation therapy, and possibly chemotherapy, depending on the tumor's characteristics. Neurological function assessment is critical, as the optic nerve is integral to vision, and any compromise can significantly impact a patient's quality of life.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise documentation of tumor location and type.
  • Involves understanding of CNS malignancies and their treatment.
  • Potential for overlapping symptoms with other neurological conditions.
  • Need for detailed imaging reports to support coding.

Audit Risk Factors

  • Inadequate documentation of tumor characteristics.
  • Failure to include imaging results in the medical record.
  • Misinterpretation of symptoms related to the optic nerve.
  • Lack of clarity on treatment plans and outcomes.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of optic nerve tumors, treatment response evaluation.

Billing Considerations

Ensure accurate staging and grading of the tumor for appropriate coding.

Neurology

Documentation Requirements

Neurological assessments, imaging results, and symptom descriptions.

Common Clinical Scenarios

Evaluation of vision changes, headaches, and neurological deficits.

Billing Considerations

Document all neurological findings to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use C72.31 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the tumor's location and characteristics
  • Include any relevant imaging studies and treatment plans in the medical record to support the diagnosis

Exclusion Criteria

Do NOT use C72.31 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

70551CPT Code

MRI of the brain with contrast

Clinical Scenario

Used to evaluate the extent of the malignant neoplasm in the optic nerve.

Documentation Requirements

Include imaging reports and interpretations in the medical record.

Specialty Considerations

Ensure that the MRI findings correlate with clinical symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of CNS malignancies, including C72.31, which enhances data accuracy and improves patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of CNS malignancies, including C72.31, which enhances data accuracy and improves patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of CNS malignancies, including C72.31, which enhances data accuracy and improves patient care tracking.

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 imaging is required for C72.31?

MRI is the preferred imaging modality to visualize the optic nerve and assess the extent of the tumor.

How do molecular markers influence coding for C72.31?

Molecular markers can provide additional information on tumor behavior and treatment options, which may be relevant for coding and documentation.