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ICD-10 Guide
ICD-10 CodesC49.5

C49.5

Billable

Malignant neoplasm of connective and soft tissue of pelvis

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

Code Description

ICD-10 C49.5 is a billable code used to indicate a diagnosis of malignant neoplasm of connective and soft tissue of pelvis.

Key Diagnostic Point:

C49.5 refers to malignant neoplasms originating from connective and soft tissues located in the pelvic region. These tumors can arise from various types of soft tissues, including muscle, fat, nerves, and blood vessels. Soft tissue sarcomas are the primary concern in this category, which can be aggressive and may metastasize to other parts of the body. The grading of these tumors is crucial, as it helps determine the prognosis and treatment options. Low-grade tumors tend to grow slowly and have a better prognosis, while high-grade tumors are more aggressive and associated with a poorer outcome. Multidisciplinary management is essential for patients with C49.5, involving surgical oncologists, medical oncologists, radiation oncologists, and pathologists to ensure comprehensive care. Treatment may include surgery, chemotherapy, and radiation therapy, tailored to the individual patient's needs and tumor characteristics. Accurate coding for C49.5 is vital for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of soft tissue sarcomas with different behaviors and treatment protocols
  • Need for precise documentation of tumor grade and stage
  • Multidisciplinary approach requiring input from various specialties
  • Potential for metastasis complicating coding and treatment

Audit Risk Factors

  • Inadequate documentation of tumor grade and histology
  • Failure to document multidisciplinary treatment approaches
  • Misclassification of tumor type or location
  • Inconsistent coding of metastatic disease

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis and treatment planning for soft tissue sarcomas, including surgical interventions and chemotherapy regimens.

Billing Considerations

Ensure accurate staging and grading of tumors to reflect treatment decisions.

Radiology

Documentation Requirements

Imaging reports must clearly indicate the location and characteristics of the tumor.

Common Clinical Scenarios

Imaging studies for diagnosis, staging, and monitoring treatment response.

Billing Considerations

Radiologists should provide detailed descriptions of imaging findings to support coding.

Coding Guidelines

Inclusion Criteria

Use C49.5 When
  • According to ICD
  • 10 guidelines, C49
  • 5 should be used when documenting malignant neoplasms of connective and soft tissue specifically located in the pelvis
  • Coders must ensure that the diagnosis is confirmed by pathology and that the tumor's grade and stage are documented

Exclusion Criteria

Do NOT use C49.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

38542CPT Code

Excision of soft tissue tumor

Clinical Scenario

Used when a patient undergoes surgical excision of a soft tissue sarcoma in the pelvis.

Documentation Requirements

Operative reports must detail the tumor's size, location, and histological type.

Specialty Considerations

Surgeons should ensure accurate coding based on the tumor's characteristics and surgical approach.

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 the accuracy of data collection and reimbursement processes. C49.5 provides a clear designation for pelvic soft tissue malignancies, facilitating better tracking of treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of soft tissue sarcomas, improving the accuracy of data collection and reimbursement processes. C49.5 provides a clear designation for pelvic soft tissue malignancies, facilitating better tracking of treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. C49.5 provides a clear designation for pelvic soft tissue malignancies, facilitating better tracking of treatment 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 C49.5?

Tumor grading is crucial as it helps determine the aggressiveness of the cancer and guides treatment decisions. High-grade tumors are more likely to metastasize and require more aggressive treatment.