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ICD-10 Guide
ICD-10 CodesC77.8

C77.8

Billable

Secondary and unspecified malignant neoplasm of lymph nodes of multiple regions

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

Code Description

ICD-10 C77.8 is a billable code used to indicate a diagnosis of secondary and unspecified malignant neoplasm of lymph nodes of multiple regions.

Key Diagnostic Point:

C77.8 refers to secondary malignant neoplasms of lymph nodes that are not specified to a particular region. This code is used when cancer has metastasized to lymph nodes from a primary tumor that is either unknown or not documented. Metastatic disease often indicates a more advanced stage of cancer, which can complicate treatment and management. The lymphatic system plays a crucial role in the spread of cancer, and involvement of multiple lymph node regions suggests a systemic process. Patients may present with symptoms such as lymphadenopathy, unexplained weight loss, or systemic symptoms related to the underlying malignancy. Accurate staging is essential for determining prognosis and treatment options, as well as for palliative care considerations, which may include symptom management and supportive care for patients with advanced disease. The complexity of coding C77.8 arises from the need for thorough documentation of the primary malignancy, staging details, and the extent of lymph node involvement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Need for accurate identification of the primary malignancy
  • Variability in lymph node involvement across different cancer types
  • Potential for multiple metastatic sites complicating coding
  • Documentation of staging and treatment history

Audit Risk Factors

  • Inadequate documentation of the primary cancer site
  • Failure to document staging information
  • Misclassification of lymph node involvement
  • Lack of clarity on whether the neoplasm is primary or secondary

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed documentation of the primary malignancy, staging, and treatment history is essential.

Common Clinical Scenarios

Patients with known primary cancers presenting with lymphadenopathy or new metastatic lesions.

Billing Considerations

Ensure that all relevant imaging and pathology reports are included to support the diagnosis.

Palliative Care

Documentation Requirements

Documentation should include symptom management strategies and patient goals of care.

Common Clinical Scenarios

Patients with advanced cancer requiring symptom relief and supportive care.

Billing Considerations

Focus on the patient's quality of life and the impact of metastatic disease on daily functioning.

Coding Guidelines

Inclusion Criteria

Use C77.8 When
  • According to ICD
  • 10 coding guidelines, C77
  • 8 should be used when there is clear documentation of secondary malignant neoplasms of lymph nodes without a specified primary site
  • Coders must ensure that the primary malignancy is documented elsewhere in the medical record

Exclusion Criteria

Do NOT use C77.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

38500CPT Code

Biopsy of lymph nodes

Clinical Scenario

Used when lymphadenopathy is evaluated for malignancy.

Documentation Requirements

Pathology report confirming malignancy and indication for biopsy.

Specialty Considerations

Oncologists should ensure that the biopsy results are linked to the diagnosis.

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. C77.8 provides a clear designation for secondary lymph node involvement, which is crucial for patient management.

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. C77.8 provides a clear designation for secondary lymph node involvement, which is crucial for patient management.

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. C77.8 provides a clear designation for secondary lymph node involvement, which is crucial for 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 is the significance of coding C77.8?

C77.8 is significant as it indicates the presence of metastatic disease in lymph nodes, which can affect treatment decisions and prognosis. Accurate coding is essential for appropriate patient management and resource allocation.