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ICD-10 Guide
ICD-10 CodesC13.2

C13.2

Billable

Malignant neoplasm of posterior wall of hypopharynx

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

Code Description

ICD-10 C13.2 is a billable code used to indicate a diagnosis of malignant neoplasm of posterior wall of hypopharynx.

Key Diagnostic Point:

C13.2 refers to a malignant neoplasm located specifically in the posterior wall of the hypopharynx, which is the part of the throat situated behind the larynx and above the esophagus. This type of cancer is often associated with risk factors such as tobacco use, heavy alcohol consumption, and human papillomavirus (HPV) infection. The hypopharynx is a critical area for swallowing and speech, and malignancies here can lead to significant morbidity. Symptoms may include dysphagia (difficulty swallowing), odynophagia (painful swallowing), hoarseness, and a lump in the neck. Diagnosis typically involves imaging studies such as CT or MRI scans, and biopsy for histological confirmation. Treatment often includes a combination of surgery, radiation therapy, and chemotherapy, depending on the stage and location of the tumor. HPV status is increasingly recognized as a significant prognostic factor, particularly in oropharyngeal cancers, influencing treatment decisions and outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of head and neck cancers
  • Understanding the implications of HPV status on treatment and prognosis
  • Navigating the complexities of staging and grading of tumors
  • Documenting the specific location of the neoplasm accurately

Audit Risk Factors

  • Inadequate documentation of HPV status
  • Failure to specify the exact location of the neoplasm
  • Misclassification of the tumor stage
  • Lack of supporting documentation for treatment decisions

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with dysphagia or neck masses, requiring biopsy and staging.

Billing Considerations

HPV testing results should be clearly documented as they influence treatment and prognosis.

Otolaryngology

Documentation Requirements

Thorough examination notes, imaging results, and surgical reports are essential.

Common Clinical Scenarios

Patients undergoing surgical resection of hypopharyngeal tumors.

Billing Considerations

Documentation must include details on the extent of resection and any reconstructive procedures performed.

Coding Guidelines

Inclusion Criteria

Use C13.2 When
  • According to ICD
  • 10 guidelines, C13
  • 2 should be used when the diagnosis is confirmed through biopsy or imaging
  • It is important to document the specific site of the neoplasm and any relevant staging information
  • malignant conditions affecting the hypopharynx

Exclusion Criteria

Do NOT use C13.2 When
  • Exclusion criteria include benign neoplasms and non

Related ICD-10 Codes

Related CPT Codes

31575CPT Code

Laryngoscopy, flexible, diagnostic

Clinical Scenario

Used for initial evaluation of suspected hypopharyngeal malignancy.

Documentation Requirements

Document findings and any biopsies taken.

Specialty Considerations

Otolaryngologists should ensure thorough documentation of the 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, including C13.2, which provides better data for epidemiological studies and treatment outcomes. This specificity aids in tracking the incidence and management of hypopharyngeal cancers.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malignancies, including C13.2, which provides better data for epidemiological studies and treatment outcomes. This specificity aids in tracking the incidence and management of hypopharyngeal cancers.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Cancer Society - Head and Neck Cancer

Coding & Billing References

  • •
    American Cancer Society - Head and Neck Cancer

Frequently Asked Questions

What is the significance of HPV status in C13.2?

HPV status is crucial as it can influence treatment decisions and prognosis. HPV-positive tumors often have a better response to treatment and improved survival rates compared to HPV-negative tumors.