ICD-10 Coding for Cavitary Lung Lesion(R91.8, C34.11)
Complete ICD-10-CM coding and documentation guide for Cavitary Lung Lesion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cavitary Lung Lesion
R91-R94Primary Range
Abnormal findings on diagnostic imaging and in function studies, without diagnosis
Used for nonspecific findings in lung imaging when etiology is not confirmed.
Malignant neoplasm of bronchus and lung
Applicable when cavitary lesion is confirmed as malignant.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R91.8 | Other nonspecific abnormal finding of lung field | Use when cavitary lesion is identified but etiology is not confirmed. |
|
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung | Use when cavitary lesion is confirmed as malignant by biopsy. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for cavitary lung lesion
Essential facts and insights about Cavitary Lung Lesion
Primary ICD-10-CM Codes for cavitary lung lesion
Decision Criteria
clinical Criteria
- Imaging shows cavitary lesion without confirmed cause.
coding Criteria
- No specific infectious or malignant cause identified.
Applicable To
- Cavitary lung lesion of unknown etiology
Clinical Validation Requirements
- Imaging report showing cavitary lesion
- No confirmed etiology from biopsy or culture
Code-Specific Risks
- Risk of undercoding if specific etiology is known.
Coding Notes
- Ensure documentation specifies lack of confirmed etiology to justify use of R91.8.
C34.11 - Malignant neoplasm of upper lobe, right bronchus or lung
Use when cavitary lesion is confirmed as malignant by biopsy.
Applicable To
- Cavitary lesion confirmed as malignant
Excludes
- Benign neoplasm of lung (D14.3)
Clinical Validation Requirements
- Pathology report confirming malignancy
- Imaging showing cavitary lesion in specified lung lobe
Coding Notes
Ensure biopsy results are documented to support malignancy coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of nicotine dependence
Z87.891Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cavitary Lung Lesion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R91.8.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Ensure all imaging reports include detailed descriptions of lesion characteristics.
Impact
Reimbursement: May result in lower reimbursement if specific codes are not used., Compliance: Risk of non-compliance with coding guidelines., Data Quality: Impacts accuracy of clinical data.
Mitigation Strategy
Use specific codes like C34.xx for malignancy or J85.2 for abscess when etiology is confirmed.
Impact
High risk of audit if R91.8 is used without proper justification.
Mitigation Strategy
Ensure documentation supports the use of nonspecific codes and consider more specific codes when possible.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Cavitary Lung Lesion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cavitary Lung Lesion
Use these documentation templates to ensure complete and accurate documentation for Cavitary Lung Lesion. These templates include all required elements for proper coding and billing.
Pulmonology Progress Note
Specialty: PulmonologyRequired Elements
- Imaging findings
- Biopsy results
- Clinical impression
- Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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