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ICD-10 Guide
ICD-10 CodesC34.81

C34.81

Billable

Malignant neoplasm of overlapping sites of right bronchus and lung

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

Code Description

ICD-10 C34.81 is a billable code used to indicate a diagnosis of malignant neoplasm of overlapping sites of right bronchus and lung.

Key Diagnostic Point:

C34.81 refers to a malignant neoplasm located at the overlapping sites of the right bronchus and lung. This type of lung cancer is characterized by uncontrolled cell growth in the tissues of the right lung and bronchus, which can lead to obstruction of airways, metastasis, and significant respiratory complications. The condition is often associated with risk factors such as smoking history, exposure to environmental toxins, and genetic predispositions. Symptoms may include persistent cough, hemoptysis, chest pain, and weight loss. Diagnosis typically involves imaging studies such as CT scans, bronchoscopy, and biopsy to confirm malignancy. Staging is crucial for determining the extent of the disease, which can range from localized tumors to advanced stages with lymph node involvement or distant metastasis. Treatment options may include surgery, chemotherapy, radiation therapy, and targeted therapies based on molecular markers. The prognosis varies significantly depending on the stage at diagnosis and the patient's overall health.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise documentation of tumor location and staging.
  • Involves understanding of overlapping site definitions.
  • Need for accurate coding of associated conditions (e.g., COPD, smoking history).
  • Complex treatment algorithms based on staging and molecular markers.

Audit Risk Factors

  • Inadequate documentation of smoking history.
  • Failure to document staging accurately.
  • Misclassification of tumor site.
  • Lack of supporting evidence for treatment decisions.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of lung cancer, staging assessments, and treatment planning.

Billing Considerations

Ensure all treatment modalities are documented, including clinical trials and molecular testing results.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging results, and smoking cessation counseling notes.

Common Clinical Scenarios

Management of respiratory symptoms, evaluation of lung function, and pre-operative assessments.

Billing Considerations

Document any co-existing pulmonary conditions that may affect treatment.

Coding Guidelines

Inclusion Criteria

Use C34.81 When
  • Follow the official ICD
  • CM coding guidelines for neoplasms, ensuring accurate documentation of the site and stage of the cancer
  • Include any relevant co
  • morbid conditions and treatment details

Exclusion Criteria

Do NOT use C34.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

32405CPT Code

Thoracotomy, with resection of lung tissue

Clinical Scenario

Used for surgical intervention in cases of localized lung cancer.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Oncology specialists should ensure accurate staging is documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of lung cancers, including overlapping sites, which enhances data accuracy and improves patient care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of lung cancers, including overlapping sites, which enhances data accuracy and improves patient care management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of lung cancers, including overlapping sites, which enhances data accuracy and improves patient care management.

Resources

Clinical References

  • •
    American Cancer Society - Lung Cancer

Coding & Billing References

  • •
    American Cancer Society - Lung Cancer

Frequently Asked Questions

What is the significance of overlapping sites in lung cancer coding?

Overlapping sites indicate that the tumor affects more than one anatomical area, which can complicate treatment and staging. Accurate coding is essential for appropriate management and reimbursement.