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v1.0.0
ICD-10 Guide
ICD-10 CodesC77.4

C77.4

Billable

Secondary and unspecified malignant neoplasm of inguinal and lower limb lymph nodes

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

Code Description

ICD-10 C77.4 is a billable code used to indicate a diagnosis of secondary and unspecified malignant neoplasm of inguinal and lower limb lymph nodes.

Key Diagnostic Point:

C77.4 refers to secondary malignant neoplasms that have metastasized to the inguinal and lower limb lymph nodes. This condition typically arises from a primary cancer located elsewhere in the body, such as the breast, prostate, or melanoma. The inguinal lymph nodes are located in the groin area, while the lower limb lymph nodes include those in the legs. The presence of malignant cells in these lymph nodes indicates advanced disease and often signifies a poor prognosis. Patients may present with swelling, pain, or discomfort in the affected area, and diagnostic imaging or biopsy may be required to confirm the metastatic nature of the disease. Staging of the cancer is crucial, as it helps determine the extent of the disease and guides treatment options. Palliative care considerations are essential for managing symptoms and improving the quality of life for patients with advanced malignancies, focusing on pain management and psychosocial support.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Determining the primary site of cancer can be challenging.
  • Need for accurate staging based on imaging and pathology reports.
  • Differentiating between primary and secondary lymph node involvement.
  • Documentation of metastatic disease requires comprehensive clinical details.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document staging information.
  • Misclassification of lymph node involvement.
  • Lack of clarity in palliative care documentation.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed history of the primary cancer, staging information, and treatment plans.

Common Clinical Scenarios

Patients with known primary cancers presenting with lymphadenopathy in the inguinal region.

Billing Considerations

Ensure accurate documentation of metastatic disease and treatment response.

Palliative Care

Documentation Requirements

Comprehensive symptom management plans and psychosocial assessments.

Common Clinical Scenarios

Patients with advanced cancer requiring symptom relief and end-of-life care.

Billing Considerations

Focus on quality of life and symptom management documentation.

Coding Guidelines

Inclusion Criteria

Use C77.4 When
  • According to the ICD
  • CM coding guidelines, C77
  • 4 should be used when there is clear documentation of secondary malignancy in the inguinal and lower limb lymph nodes
  • Coders must ensure that the primary site of cancer is documented and that staging information is included when applicable

Exclusion Criteria

Do NOT use C77.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

38500CPT Code

Biopsy of lymph nodes

Clinical Scenario

Used when a biopsy is performed to confirm metastatic disease in lymph nodes.

Documentation Requirements

Pathology report confirming malignancy and documentation of the procedure.

Specialty Considerations

Oncology specialists should ensure thorough documentation of findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of cancer registries and treatment planning. C77.4 provides a clear distinction for secondary malignancies, which aids in research and epidemiological studies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of cancer registries and treatment planning. C77.4 provides a clear distinction for secondary malignancies, which aids in research and epidemiological studies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of cancer registries and treatment planning. C77.4 provides a clear distinction for secondary malignancies, which aids in research and epidemiological studies.

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 coding C77.4?

Coding C77.4 accurately reflects the presence of metastatic disease in the inguinal and lower limb lymph nodes, which is crucial for treatment planning and prognosis.