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ICD-10 Guide
ICD-10 CodesC02.4

C02.4

Billable

Malignant neoplasm of lingual tonsil

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

Code Description

ICD-10 C02.4 is a billable code used to indicate a diagnosis of malignant neoplasm of lingual tonsil.

Key Diagnostic Point:

Malignant neoplasm of the lingual tonsil is a rare form of cancer that arises from the lymphoid tissue located at the base of the tongue. This neoplasm is classified under the broader category of head and neck cancers, specifically affecting the oropharynx. The lingual tonsils are part of the immune system and play a role in protecting against infections. Symptoms may include difficulty swallowing, sore throat, and changes in voice. Diagnosis typically involves a combination of physical examination, imaging studies, and biopsy to confirm malignancy. Treatment options may include surgery, radiation therapy, and chemotherapy, depending on the stage of the cancer. The prognosis varies based on the tumor's size, location, and whether it has metastasized to nearby lymph nodes or distant organs. Early detection and intervention are crucial for improving outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in staging based on tumor size and lymph node involvement
  • Need for precise documentation of tumor characteristics
  • Potential for multiple treatment modalities affecting coding
  • Differentiation from benign lesions and other malignancies in the oropharynx

Audit Risk Factors

  • Inadequate documentation of tumor staging
  • Failure to capture all treatment modalities used
  • Misclassification of the tumor site
  • Lack of follow-up documentation post-treatment

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed descriptions of tumor characteristics, staging, and treatment plans.

Common Clinical Scenarios

Patients presenting with throat pain, dysphagia, or neck masses.

Billing Considerations

Ensure accurate staging and documentation of any surgical interventions.

Oncology

Documentation Requirements

Comprehensive treatment plans including chemotherapy and radiation therapy details.

Common Clinical Scenarios

Management of patients undergoing multimodal treatment for head and neck cancers.

Billing Considerations

Document all aspects of care, including palliative measures and follow-up.

Coding Guidelines

Inclusion Criteria

Use C02.4 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the primary site and any metastatic involvement
  • Include details on the type of malignancy and any relevant treatment history

Exclusion Criteria

Do NOT use C02.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

21550CPT Code

Excision, malignant tumor, head and neck

Clinical Scenario

Used when a patient undergoes surgical excision of the lingual tonsil malignancy.

Documentation Requirements

Document the size and location of the tumor, as well as any lymph node involvement.

Specialty Considerations

Otolaryngologists should ensure comprehensive documentation of surgical findings.

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. C02.4 provides a clear distinction for malignant neoplasms of the lingual tonsil, which aids in research 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. C02.4 provides a clear distinction for malignant neoplasms of the lingual tonsil, which aids in research and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. C02.4 provides a clear distinction for malignant neoplasms of the lingual tonsil, which aids in research and treatment planning.

Resources

Clinical References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery

Coding & Billing References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery

Frequently Asked Questions

What are the common symptoms of malignant neoplasm of the lingual tonsil?

Common symptoms include sore throat, difficulty swallowing, changes in voice, and neck swelling due to lymph node involvement.