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v1.0.0
ICD-10 Guide
ICD-10 CodesC05.2

C05.2

Billable

Malignant neoplasm of uvula

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

Code Description

ICD-10 C05.2 is a billable code used to indicate a diagnosis of malignant neoplasm of uvula.

Key Diagnostic Point:

Malignant neoplasm of the uvula is a rare form of cancer that arises from the tissues of the uvula, which is the small, fleshy extension at the back of the soft palate. This condition is classified under oral cavity malignancies and can present with symptoms such as sore throat, difficulty swallowing, and changes in voice. The uvula is part of the oropharynx, and malignancies in this area can be associated with risk factors such as tobacco use, alcohol consumption, and human papillomavirus (HPV) infection. Diagnosis typically involves a thorough clinical examination, imaging studies, and biopsy to confirm malignancy. Treatment often requires a multidisciplinary approach, including surgical intervention, radiation therapy, and possibly chemotherapy, depending on the stage and extent of the disease. Dental considerations are crucial, as patients may experience oral complications post-treatment, necessitating collaboration between oncologists and dental professionals to manage oral health effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Rarity of the condition leading to limited coding experience.
  • Need for precise documentation of tumor location and staging.
  • Potential for overlapping symptoms with benign conditions.
  • Variability in treatment approaches requiring detailed coding.

Audit Risk Factors

  • Inadequate documentation of the malignancy's extent.
  • Failure to capture multidisciplinary treatment approaches.
  • Misclassification of the neoplasm as benign.
  • Lack of clarity in patient history regarding risk factors.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed staging of the tumor, treatment plans, and follow-up care.

Common Clinical Scenarios

Patients presenting with oropharyngeal symptoms and confirmed malignancy.

Billing Considerations

Coordination with dental specialists for post-treatment oral care.

Dentistry

Documentation Requirements

Records of oral examinations, treatment of complications, and patient education.

Common Clinical Scenarios

Management of oral side effects from cancer treatments, such as xerostomia.

Billing Considerations

Awareness of the patient's cancer treatment history to avoid complications.

Coding Guidelines

Inclusion Criteria

Use C05.2 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, treatment, and any associated conditions
  • Include specific details about the tumor's location and staging

Exclusion Criteria

Do NOT use C05.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

42820CPT Code

Excision of uvula

Clinical Scenario

Used when a malignant neoplasm of the uvula is surgically excised.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Oncologists and ENT specialists should collaborate on documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of oral cavity malignancies, improving data accuracy and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of oral cavity malignancies, improving data accuracy and facilitating better patient management.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Cancer Society - Oral Cavity Cancer

Coding & Billing References

  • •
    American Cancer Society - Oral Cavity Cancer

Frequently Asked Questions

What are the common symptoms of malignant neoplasm of the uvula?

Common symptoms include sore throat, difficulty swallowing, changes in voice, and visible lesions on the uvula.

How is a malignant neoplasm of the uvula diagnosed?

Diagnosis typically involves clinical examination, imaging studies, and biopsy to confirm malignancy.

What treatment options are available for this condition?

Treatment may include surgical excision, radiation therapy, and chemotherapy, depending on the stage of the cancer.