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ICD-10 Guide
ICD-10 CodesC79.3

C79.3

Billable

Secondary malignant neoplasm of brain and cerebral meninges

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

Code Description

ICD-10 C79.3 is a billable code used to indicate a diagnosis of secondary malignant neoplasm of brain and cerebral meninges.

Key Diagnostic Point:

C79.3 refers to secondary malignant neoplasms that have metastasized to the brain and cerebral meninges from a primary tumor located elsewhere in the body. This condition is characterized by the presence of malignant cells in the brain or its protective membranes, which can arise from various primary cancers, including lung, breast, melanoma, and others. The clinical presentation may include neurological deficits, headaches, seizures, and changes in mental status, depending on the location and extent of the metastasis. Diagnosis typically involves imaging studies such as MRI or CT scans, along with histopathological confirmation through biopsy. Staging of metastatic brain tumors is crucial for treatment planning and prognosis, often utilizing the TNM (Tumor, Node, Metastasis) system, although specific staging for brain metastases may differ. Palliative care considerations are essential, focusing on symptom management and quality of life, especially in advanced disease stages where curative treatment is not feasible. Multidisciplinary approaches involving oncologists, neurologists, and palliative care specialists are often employed to address the complex needs of these patients.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Determining the primary site of cancer can be challenging.
  • Need for precise documentation of metastatic disease.
  • Staging complexities due to varying primary cancers.
  • Differentiating between primary brain tumors and metastases.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document staging details.
  • Misclassification of primary versus secondary tumors.
  • Lack of palliative care documentation.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed history of the primary cancer, treatment history, and imaging results.

Common Clinical Scenarios

Patients with known primary cancers presenting with neurological symptoms.

Billing Considerations

Ensure accurate staging and documentation of treatment plans.

Neurology

Documentation Requirements

Neurological assessments, imaging findings, and symptomatology.

Common Clinical Scenarios

Patients presenting with seizures or cognitive changes due to metastasis.

Billing Considerations

Document neurological deficits and their impact on daily functioning.

Coding Guidelines

Inclusion Criteria

Use C79.3 When
  • According to ICD
  • 10 coding guidelines, C79
  • 3 should be used when there is clear documentation of metastatic disease to the brain or meninges
  • It is essential to confirm the primary site of cancer when applicable

Exclusion Criteria

Do NOT use C79.3 When
  • Exclusion criteria include cases where the brain tumor is primary rather than metastatic

Related ICD-10 Codes

Related CPT Codes

70450CPT Code

CT scan of the head

Clinical Scenario

Used to evaluate for brain metastases in patients with known primary cancers.

Documentation Requirements

Document indications for the scan and findings.

Specialty Considerations

Oncologists and neurologists should collaborate on imaging findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of data collection and reimbursement processes. C79.3 provides a clear distinction between primary and secondary tumors, which is crucial for treatment planning and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of data collection and reimbursement processes. C79.3 provides a clear distinction between primary and secondary tumors, which is crucial for treatment planning and research.

Reimbursement & Billing Impact

reimbursement processes. C79.3 provides a clear distinction between primary and secondary tumors, which is crucial for treatment planning and research.

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 is the significance of coding C79.3 accurately?

Accurate coding of C79.3 is crucial for appropriate treatment planning, reimbursement, and understanding the epidemiology of metastatic brain tumors. It ensures that patients receive the necessary care and resources based on their specific diagnosis.