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v1.0.0
ICD-10 Guide
ICD-10 CodesC02.1

C02.1

Billable

Malignant neoplasm of border of tongue

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

Code Description

ICD-10 C02.1 is a billable code used to indicate a diagnosis of malignant neoplasm of border of tongue.

Key Diagnostic Point:

Malignant neoplasm of the border of the tongue refers to cancerous growths that occur at the lateral or anterior margins of the tongue. This type of cancer is often squamous cell carcinoma, which is the most common form of oral cancer. Symptoms may include a persistent sore or ulcer on the tongue, difficulty swallowing, and changes in speech. Diagnosis typically involves a biopsy, imaging studies, and thorough clinical examination. Treatment options may include surgical resection, radiation therapy, and chemotherapy, depending on the stage of the disease. The prognosis varies based on the tumor's size, location, and whether it has metastasized. Early detection is crucial for improving outcomes, as advanced stages can lead to significant morbidity and impact on quality of life, particularly concerning speech and swallowing functions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in staging and treatment options based on tumor size and location
  • Need for precise documentation of tumor characteristics and treatment plans
  • Potential for multiple specialties to be involved in care (e.g., oncology, ENT)
  • Complexity in distinguishing between benign and malignant lesions

Audit Risk Factors

  • Inadequate documentation of tumor size and margins
  • Failure to document staging details
  • Misclassification of tumor type (benign vs. malignant)
  • Inconsistent coding of treatment modalities

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed treatment plans, staging information, and follow-up care documentation.

Common Clinical Scenarios

Management of patients undergoing chemotherapy or radiation therapy for tongue malignancies.

Billing Considerations

Ensure accurate documentation of treatment response and any complications.

Otolaryngology

Documentation Requirements

Surgical notes, pathology reports, and imaging studies.

Common Clinical Scenarios

Surgical resection of tongue tumors and post-operative care.

Billing Considerations

Document the extent of resection and any reconstructive procedures performed.

Coding Guidelines

Inclusion Criteria

Use C02.1 When
  • Follow official ICD
  • CM guidelines for coding neoplasms, including the need for accurate staging and documentation of treatment
  • Ensure to use additional codes for any associated conditions or complications

Exclusion Criteria

Do NOT use C02.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

21045CPT Code

Excision, malignant tumor of tongue

Clinical Scenario

Used when a patient undergoes surgical excision of a malignant neoplasm of the tongue.

Documentation Requirements

Surgical notes detailing the extent of excision and pathology results.

Specialty Considerations

Otolaryngology specialists should ensure accurate coding of the surgical procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of malignancies, improving the accuracy of data collection and reimbursement processes. C02.1 provides a clear distinction for malignant neoplasms of the tongue border, enhancing clinical understanding and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malignancies, improving the accuracy of data collection and reimbursement processes. C02.1 provides a clear distinction for malignant neoplasms of the tongue border, enhancing clinical understanding and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. C02.1 provides a clear distinction for malignant neoplasms of the tongue border, enhancing clinical understanding and treatment planning.

Resources

Clinical References

  • •
    American Cancer Society - Oral Cancers

Coding & Billing References

  • •
    American Cancer Society - Oral Cancers

Frequently Asked Questions

What are the common symptoms of malignant neoplasm of the border of the tongue?

Common symptoms include persistent sores or ulcers on the tongue, difficulty swallowing, changes in speech, and localized pain.