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ICD-10 Guide
ICD-10 CodesC49.21

C49.21

Billable

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

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

Code Description

ICD-10 C49.21 is a billable code used to indicate a diagnosis of malignant neoplasm of connective and soft tissue of right lower limb, including hip.

Key Diagnostic Point:

C49.21 refers to malignant neoplasms originating from connective and soft tissues in the right lower limb, including the hip. 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 vary significantly in terms of histological subtype, grade, and clinical behavior. The grading of soft tissue sarcomas is crucial as it influences treatment decisions and prognosis. High-grade tumors tend to be more aggressive and have a higher likelihood of metastasis. Multidisciplinary management is essential for optimal outcomes, involving surgical oncologists, medical oncologists, radiation oncologists, and pathologists. Treatment may include surgical resection, chemotherapy, and radiation therapy, tailored to the individual patient's tumor characteristics and overall health status. Accurate coding of C49.21 requires thorough documentation of the tumor's location, histology, and treatment plan, as well as any relevant patient history that may impact management.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of histological subtypes of soft tissue sarcomas
  • Need for precise documentation of tumor location and grade
  • Multidisciplinary treatment approaches complicating coding
  • Potential for metastasis requiring additional codes

Audit Risk Factors

  • Inadequate documentation of tumor grade
  • Failure to specify the exact location of the neoplasm
  • Misclassification of tumor type or subtype
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, treatment plans, and follow-up notes.

Common Clinical Scenarios

Diagnosis and management of soft tissue sarcomas, staging, and treatment response assessments.

Billing Considerations

Ensure accurate grading and staging documentation to support coding.

Surgery

Documentation Requirements

Operative reports detailing the extent of resection and any complications.

Common Clinical Scenarios

Surgical intervention for tumor resection and reconstruction.

Billing Considerations

Document the surgical margins and any adjuvant therapies planned.

Coding Guidelines

Inclusion Criteria

Use C49.21 When
  • According to ICD
  • CM guidelines, C49
  • 21 should be used when the malignant neoplasm is confirmed by pathology and is specifically located in the right lower limb

Exclusion Criteria

Do NOT use C49.21 When
  • Exclusion criteria include benign tumors and neoplasms of other anatomical sites

Related ICD-10 Codes

Related CPT Codes

27401CPT Code

Excision, tumor, soft tissue of lower limb

Clinical Scenario

Used during surgical resection of a soft tissue sarcoma.

Documentation Requirements

Operative report detailing the tumor 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 tracking of treatment outcomes and epidemiological studies.

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 tracking of treatment outcomes and epidemiological studies.

Reimbursement & Billing Impact

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

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 is crucial as it helps determine the aggressiveness of the cancer, guides treatment decisions, and provides prognostic information.