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ICD-10 Guide
ICD-10 CodesC10.1

C10.1

Billable

Malignant neoplasm of anterior surface of epiglottis

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

Code Description

ICD-10 C10.1 is a billable code used to indicate a diagnosis of malignant neoplasm of anterior surface of epiglottis.

Key Diagnostic Point:

C10.1 refers to a malignant neoplasm located on the anterior surface of the epiglottis, which is a flap of cartilage located at the root of the tongue that prevents food from entering the windpipe during swallowing. This type of cancer is categorized under oropharyngeal cancers, which can arise from various risk factors, including tobacco use, alcohol consumption, and human papillomavirus (HPV) infection. HPV-positive oropharyngeal cancers have been increasingly recognized, particularly in younger populations, and are often associated with a better prognosis compared to HPV-negative cases. Treatment typically involves a combination of surgery, radiation therapy, and chemotherapy, depending on the stage and location of the tumor. Radiation therapy is particularly significant in managing this condition, as it can be used as a primary treatment or adjuvantly following surgery to eliminate residual cancer cells. Accurate coding of C10.1 is crucial for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various sites of oropharyngeal cancers.
  • Understanding the implications of HPV status on treatment and prognosis.
  • Navigating the nuances of staging and grading of the neoplasm.
  • Documenting the specific location and characteristics of the tumor.

Audit Risk Factors

  • Inadequate documentation of tumor location.
  • Failure to document HPV status.
  • Incorrect staging of the neoplasm.
  • Lack of clarity on treatment modalities used.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed descriptions of the tumor's size, location, and staging, as well as treatment plans.

Common Clinical Scenarios

Patients presenting with dysphagia, hoarseness, or a neck mass.

Billing Considerations

Ensure documentation reflects the multidisciplinary approach often required for treatment.

Oncology

Documentation Requirements

Comprehensive treatment history, including chemotherapy and radiation details.

Common Clinical Scenarios

Management of patients undergoing radiation therapy post-surgery.

Billing Considerations

Documenting the response to treatment and any complications that arise.

Coding Guidelines

Inclusion Criteria

Use C10.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the tumor's location, size, and any relevant treatment details
  • Include any relevant history of HPV status, as it may influence treatment decisions

Exclusion Criteria

Do NOT use C10.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

31575CPT Code

Laryngoscopy, flexible, diagnostic

Clinical Scenario

Used for initial evaluation of suspected C10.1.

Documentation Requirements

Document findings from the laryngoscopy and any biopsies taken.

Specialty Considerations

Otolaryngologists should ensure thorough documentation of the procedure and findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of oropharyngeal cancers, including C10.1, which enhances the ability to track treatment outcomes and epidemiological data.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of oropharyngeal cancers, including C10.1, which enhances the ability to track treatment outcomes and epidemiological data.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of oropharyngeal cancers, including C10.1, which enhances the ability to track treatment outcomes and epidemiological data.

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 is the significance of HPV status in C10.1?

HPV status is crucial as it can influence treatment options and prognosis. HPV-positive oropharyngeal cancers often respond better to treatment and have a different clinical course compared to HPV-negative cases.