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ICD-10 Guide
ICD-10 CodesC75.4

C75.4

Billable

Malignant neoplasm of carotid body

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

Code Description

ICD-10 C75.4 is a billable code used to indicate a diagnosis of malignant neoplasm of carotid body.

Key Diagnostic Point:

The carotid body is a small cluster of chemoreceptors and supporting cells located at the bifurcation of the common carotid artery. It plays a crucial role in the regulation of respiratory and cardiovascular functions by detecting changes in blood oxygen, carbon dioxide, and pH levels. A malignant neoplasm of the carotid body, classified under ICD-10 code C75.4, is a rare tumor that arises from the paraganglionic tissue of the carotid body. These tumors are typically slow-growing and may be asymptomatic in the early stages. Symptoms, when present, can include neck swelling, pain, or neurological deficits due to local invasion or compression of adjacent structures. The diagnosis is often confirmed through imaging studies such as CT or MRI, and histopathological examination following biopsy. Treatment usually involves surgical excision, and in some cases, radiation therapy may be indicated. Due to its endocrine nature, the tumor may also influence hormone levels, leading to metabolic changes that require careful monitoring and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Rarity of the condition leading to limited coding experience
  • Need for precise documentation of tumor characteristics
  • Potential for misclassification with benign neoplasms
  • Variability in clinical presentation and symptoms

Audit Risk Factors

  • Inadequate documentation of tumor size and location
  • Failure to specify the malignant nature of the neoplasm
  • Misinterpretation of imaging results
  • Lack of follow-up documentation post-treatment

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 carotid body tumors, including surgical interventions.

Billing Considerations

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

Endocrinology

Documentation Requirements

Hormonal assessment results and metabolic evaluations should be included.

Common Clinical Scenarios

Management of metabolic changes due to hormone secretion from the tumor.

Billing Considerations

Monitor for potential endocrine dysfunction and document any related symptoms.

Coding Guidelines

Inclusion Criteria

Use C75.4 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging and pathology reports to substantiate the coding decision

Exclusion Criteria

Do NOT use C75.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

38792CPT Code

Lymphatic mapping and sentinel node biopsy

Clinical Scenario

Used in conjunction with surgical excision of the tumor.

Documentation Requirements

Document the indication for lymphatic mapping and the findings.

Specialty Considerations

Oncology specialists should ensure accurate coding of the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of rare conditions like malignant neoplasms of the carotid body, improving data accuracy and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of rare conditions like malignant neoplasms of the carotid body, improving data accuracy and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of rare conditions like malignant neoplasms of the carotid body, improving data accuracy and facilitating better patient management.

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 are the common symptoms of a malignant neoplasm of the carotid body?

Common symptoms include neck swelling, pain, and neurological deficits due to local invasion. Some patients may also experience symptoms related to hormonal secretion, such as hypertension.