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v1.0.0
ICD-10 Guide
ICD-10 CodesC46.5

C46.5

Billable

Kaposi's sarcoma of lung

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

Code Description

ICD-10 C46.5 is a billable code used to indicate a diagnosis of kaposi's sarcoma of lung.

Key Diagnostic Point:

Kaposi's sarcoma (KS) is a type of cancer that arises from the endothelial cells lining blood vessels and is characterized by the formation of tumors in the skin, lymph nodes, and other organs, including the lungs. It is most commonly associated with immunocompromised states, particularly in individuals with HIV/AIDS. In the lungs, KS can present with symptoms such as cough, hemoptysis, and respiratory distress, often leading to significant morbidity. The lesions may be asymptomatic or can cause pulmonary complications due to their location and size. Diagnosis typically involves imaging studies, such as chest X-rays or CT scans, and may require biopsy for histological confirmation. Treatment options for pulmonary KS include antiretroviral therapy (ART) for HIV-positive patients, chemotherapy, and localized radiation therapy, depending on the extent of the disease and the patient's overall health status. The prognosis varies widely based on the stage of the disease and the effectiveness of the underlying HIV treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of HIV/AIDS associations
  • Differentiation from other lung cancers
  • Need for accurate staging of the disease
  • Potential for multiple treatment modalities

Audit Risk Factors

  • Inadequate documentation of HIV status
  • Failure to document treatment response
  • Misclassification of KS as another lung cancer type
  • Lack of detailed clinical notes on symptoms

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed treatment plans, staging information, and response to therapy.

Common Clinical Scenarios

Patients presenting with respiratory symptoms and known HIV status.

Billing Considerations

Ensure accurate staging and treatment documentation to support coding.

Infectious Disease

Documentation Requirements

Comprehensive history of HIV treatment and immunosuppression.

Common Clinical Scenarios

Management of HIV-positive patients with opportunistic infections or malignancies.

Billing Considerations

Documenting the relationship between HIV status and KS development.

Coding Guidelines

Inclusion Criteria

Use C46.5 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the patient's HIV status and any related complications
  • Include details on the extent of KS involvement in the lungs and any treatments administered

Exclusion Criteria

Do NOT use C46.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

96413CPT Code

Chemotherapy administration, intravenous

Clinical Scenario

Used when administering chemotherapy for KS treatment.

Documentation Requirements

Document the drug administered, dosage, and patient response.

Specialty Considerations

Oncology specialists must ensure accurate coding of chemotherapy sessions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Kaposi's sarcoma, improving the ability to capture the nuances of the disease, particularly its association with HIV/AIDS and its various presentations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Kaposi's sarcoma, improving the ability to capture the nuances of the disease, particularly its association with HIV/AIDS and its various presentations.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of Kaposi's sarcoma, improving the ability to capture the nuances of the disease, particularly its association with HIV/AIDS and its various presentations.

Resources

Clinical References

  • •
    Kaposi's Sarcoma Foundation

Coding & Billing References

  • •
    Kaposi's Sarcoma Foundation

Frequently Asked Questions

What is the significance of coding C46.5 accurately?

Accurate coding of C46.5 is crucial for proper reimbursement, tracking of KS cases, and ensuring that patients receive appropriate care based on their HIV status and treatment needs.