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ICD-10 Guide
ICD-10 CodesC72.42

C72.42

Billable

Malignant neoplasm of left acoustic nerve

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

Code Description

ICD-10 C72.42 is a billable code used to indicate a diagnosis of malignant neoplasm of left acoustic nerve.

Key Diagnostic Point:

C72.42 refers to a malignant neoplasm located on the left acoustic nerve, which is responsible for transmitting sound and balance information from the inner ear to the brain. This type of tumor can arise from Schwann cells, leading to a condition known as vestibular schwannoma or acoustic neuroma. Symptoms may include hearing loss, tinnitus, and balance disturbances. Imaging studies, particularly MRI, are crucial for diagnosis, as they provide detailed views of the tumor's size, location, and effect on surrounding structures. Molecular markers, such as mutations in the NF2 gene, may also be evaluated to understand the tumor's biology and potential treatment responses. Neurological function can be significantly impacted, necessitating a multidisciplinary approach for management, including surgical intervention, radiation therapy, and rehabilitation services. Accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires precise anatomical localization of the tumor.
  • Differentiation from benign neoplasms like vestibular schwannomas.
  • Potential for overlapping symptoms with other neurological conditions.
  • Need for comprehensive imaging documentation.

Audit Risk Factors

  • Inadequate documentation of imaging results.
  • Failure to specify laterality in clinical notes.
  • Misclassification of benign versus malignant tumors.
  • Lack of detailed treatment plans in medical records.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed audiological assessments and imaging reports.

Common Clinical Scenarios

Patients presenting with unilateral hearing loss and tinnitus.

Billing Considerations

Ensure clear documentation of symptoms and imaging findings to support the diagnosis.

Neurosurgery

Documentation Requirements

Surgical reports detailing tumor resection and neurological assessments.

Common Clinical Scenarios

Patients undergoing surgical intervention for acoustic neuromas.

Billing Considerations

Documenting the extent of resection and any complications is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use C72.42 When
  • Follow official ICD
  • CM guidelines for coding neoplasms, ensuring accurate documentation of laterality and tumor behavior
  • Include any relevant imaging studies and clinical findings to support the diagnosis

Exclusion Criteria

Do NOT use C72.42 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

61548CPT Code

Excision of acoustic neuroma

Clinical Scenario

Used when surgical intervention is performed for a malignant neoplasm of the acoustic nerve.

Documentation Requirements

Surgical reports must detail the procedure and any complications.

Specialty Considerations

Neurosurgeons should document the extent of tumor resection and neurological assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of malignant neoplasms, improving the accuracy of data collection and reimbursement processes. C72.42 provides a clear distinction between malignant and benign conditions, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malignant neoplasms, improving the accuracy of data collection and reimbursement processes. C72.42 provides a clear distinction between malignant and benign conditions, facilitating better patient management.

Reimbursement & Billing Impact

reimbursement processes. C72.42 provides a clear distinction between malignant and benign conditions, facilitating better patient management.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What imaging is required for diagnosing C72.42?

MRI is the preferred imaging modality for diagnosing malignant neoplasms of the acoustic nerve, providing detailed information about the tumor's size and location.