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ICD-10 Guide
ICD-10 CodesC49.20

C49.20

Billable

Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip

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

Code Description

ICD-10 C49.20 is a billable code used to indicate a diagnosis of malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip.

Key Diagnostic Point:

C49.20 refers to malignant neoplasms originating from connective and soft tissues in the lower limb, including the hip region. Soft tissue sarcomas are a diverse group of tumors that arise from mesenchymal tissues, which include muscle, fat, blood vessels, nerves, and fibrous tissues. These tumors can be aggressive and may metastasize to distant sites. The diagnosis often involves imaging studies such as MRI or CT scans, followed by a biopsy to confirm malignancy. Grading of soft tissue sarcomas is crucial, as it helps determine the prognosis and treatment approach. The tumors are typically graded based on histological features, including cellularity, pleomorphism, and necrosis. Multidisciplinary management is essential, involving surgical oncologists, medical oncologists, and radiation oncologists to optimize treatment outcomes. Surgical resection is the primary treatment modality, often followed by adjuvant therapies depending on the tumor's grade and stage. Regular follow-up is necessary to monitor for recurrence or metastasis.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in tumor types and grades
  • Need for precise documentation of tumor location and characteristics
  • Multidisciplinary treatment approaches
  • Potential for metastasis requiring additional coding

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to specify laterality when applicable
  • Misclassification of tumor grade
  • Lack of multidisciplinary treatment documentation

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of soft tissue sarcomas, treatment planning, and follow-up care.

Billing Considerations

Ensure accurate grading and staging documentation to support treatment decisions.

Surgery

Documentation Requirements

Operative reports detailing tumor resection and margins.

Common Clinical Scenarios

Surgical intervention for tumor removal and reconstruction.

Billing Considerations

Document the extent of resection and any complications.

Coding Guidelines

Inclusion Criteria

Use C49.20 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the tumor's characteristics, including laterality and grade
  • Use additional codes as necessary to capture any associated conditions or complications

Exclusion Criteria

Do NOT use C49.20 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27087CPT Code

Excision, soft tissue tumor

Clinical Scenario

Used for surgical removal of the soft tissue sarcoma.

Documentation Requirements

Operative report detailing the tumor's size, location, and margins.

Specialty Considerations

Ensure the surgical approach 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 soft tissue sarcomas, improving data accuracy and facilitating better treatment planning and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of soft tissue sarcomas, improving data accuracy and facilitating better treatment planning and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of soft tissue sarcomas, improving data accuracy and facilitating better treatment planning and outcomes.

Resources

Clinical References

  • •
    American Cancer Society - Soft Tissue Sarcoma

Coding & Billing References

  • •
    American Cancer Society - Soft Tissue Sarcoma

Frequently Asked Questions

What is the significance of tumor grading in soft tissue sarcomas?

Tumor grading helps determine the aggressiveness of the cancer and guides treatment decisions. Higher-grade tumors are typically more aggressive and may require more intensive treatment.