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ICD-10 Guide
ICD-10 CodesC79.4

C79.4

Billable

Secondary malignant neoplasm of other and unspecified parts of nervous system

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

Code Description

ICD-10 C79.4 is a billable code used to indicate a diagnosis of secondary malignant neoplasm of other and unspecified parts of nervous system.

Key Diagnostic Point:

C79.4 refers to secondary malignant neoplasms that have metastasized to the nervous system, specifically to areas not classified under more specific codes for the brain or spinal cord. This condition arises when cancer cells from a primary tumor spread to the nervous system, leading to various neurological symptoms depending on the location and extent of the metastasis. Common primary cancers that may lead to C79.4 include lung, breast, and melanoma. Patients may present with headaches, seizures, cognitive changes, or focal neurological deficits. Diagnosis typically involves imaging studies such as MRI or CT scans, alongside histopathological confirmation. Management often focuses on palliative care, including symptom control and quality of life improvement, as the prognosis can be poor depending on the extent of disease and response to treatment. Understanding the nuances of this code is crucial for accurate billing and appropriate patient care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the primary site of cancer can be challenging.
  • Differentiating between primary and secondary tumors in the nervous system.
  • Need for precise documentation of metastatic disease.
  • Staging considerations that may affect treatment options.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document the extent of metastasis.
  • Misclassification of primary vs. secondary tumors.
  • Lack of staging information.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Clear documentation of the primary cancer diagnosis and treatment history.

Common Clinical Scenarios

Patients with known primary cancers presenting with neurological symptoms.

Billing Considerations

Ensure that all imaging and pathology reports are included in the medical record.

Neurology

Documentation Requirements

Detailed neurological assessments and imaging results.

Common Clinical Scenarios

Patients presenting with new neurological deficits or seizures.

Billing Considerations

Document the neurological examination findings thoroughly to support coding.

Coding Guidelines

Inclusion Criteria

Use C79.4 When
  • According to ICD
  • 10 guidelines, C79
  • 4 should be used when there is clear evidence of metastasis to the nervous system without a specified primary site
  • Coders must ensure that documentation supports the diagnosis of secondary malignancy

Exclusion Criteria

Do NOT use C79.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

70450CPT Code

CT scan of the head or brain

Clinical Scenario

Used to evaluate for metastasis in patients with known primary cancers.

Documentation Requirements

Indicate the reason for the scan and any symptoms present.

Specialty Considerations

Oncology and neurology should coordinate to ensure comprehensive care.

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 accuracy of cancer registries and treatment planning. C79.4 provides a distinct code for secondary tumors in the nervous system, which was less clearly defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of secondary malignancies, improving the accuracy of cancer registries and treatment planning. C79.4 provides a distinct code for secondary tumors in the nervous system, which was less clearly defined in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of secondary malignancies, improving the accuracy of cancer registries and treatment planning. C79.4 provides a distinct code for secondary tumors in the nervous system, which was less clearly defined in ICD-9.

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 C79.4 accurately?

Accurate coding of C79.4 is crucial for proper reimbursement, tracking of cancer statistics, and ensuring that patients receive appropriate care based on their metastatic disease status.