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ICD-10 Guide
ICD-10 CodesC78.00

C78.00

Billable

Secondary malignant neoplasm of unspecified lung

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

Code Description

ICD-10 C78.00 is a billable code used to indicate a diagnosis of secondary malignant neoplasm of unspecified lung.

Key Diagnostic Point:

C78.00 refers to secondary malignant neoplasms that have metastasized to the lung from an unknown primary site. This condition is characterized by the presence of cancerous cells in the lung tissue that originated from another part of the body. The lung is a common site for metastasis due to its extensive blood supply and lymphatic drainage. Patients may present with respiratory symptoms, such as cough, dyspnea, or hemoptysis, but often the diagnosis is made incidentally during imaging studies for other reasons. Staging of metastatic lung cancer is crucial for determining prognosis and treatment options, typically classified using the TNM system (Tumor, Node, Metastasis). Palliative care considerations are paramount, as many patients with secondary lung malignancies may have advanced disease and require symptom management, including pain control and psychosocial support. The unknown primary nature of the neoplasm complicates treatment planning, necessitating a multidisciplinary approach to care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the primary site of cancer can be challenging.
  • Need for thorough documentation of metastatic disease.
  • Staging considerations may vary based on the patient's overall health.
  • Palliative care needs may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document staging details.
  • Misclassification of primary versus secondary lung cancer.
  • Lack of clarity in palliative care documentation.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed history of cancer diagnosis, treatment history, and staging information.

Common Clinical Scenarios

Patients presenting with respiratory symptoms and known history of malignancy.

Billing Considerations

Ensure clear documentation of the primary site when known and the nature of metastasis.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging studies, and symptom management documentation.

Common Clinical Scenarios

Patients with respiratory distress and a history of cancer.

Billing Considerations

Document any interventions for respiratory symptoms and their outcomes.

Coding Guidelines

Inclusion Criteria

Use C78.00 When
  • According to ICD
  • 10 coding guidelines, C78
  • 00 should be used when there is clear documentation of metastatic disease to the lung without a specified primary site
  • Coders should ensure that the documentation supports the diagnosis and that all relevant clinical information is included

Exclusion Criteria

Do NOT use C78.00 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Office or other outpatient visit, established patient

Clinical Scenario

Used for follow-up visits for patients with known metastatic lung cancer.

Documentation Requirements

Document the patient's history, examination findings, and any treatment changes.

Specialty Considerations

Oncology specialists should ensure comprehensive documentation of cancer history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of secondary malignancies, improving the granularity of data for epidemiological studies and treatment outcomes. C78.00 provides a clear designation for secondary lung neoplasms, facilitating better tracking and management of these patients.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of secondary malignancies, improving the granularity of data for epidemiological studies and treatment outcomes. C78.00 provides a clear designation for secondary lung neoplasms, facilitating better tracking and management of these patients.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of secondary malignancies, improving the granularity of data for epidemiological studies and treatment outcomes. C78.00 provides a clear designation for secondary lung neoplasms, facilitating better tracking and management of these patients.

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 C78.00?

Coding C78.00 is crucial for accurately representing the patient's condition of secondary lung malignancy, which impacts treatment decisions, prognosis, and healthcare resource allocation.