ICD-10 Coding for Marginal Zone Lymphoma(C85.87, C88.4)
Complete ICD-10-CM coding and documentation guide for Marginal Zone Lymphoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Marginal Zone Lymphoma
C85.8-C85.9Primary Range
Other specified and unspecified types of non-Hodgkin lymphoma
Includes nodal marginal zone lymphoma and other specified types.
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma)
Specifically for extranodal MALT lymphoma.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C85.87 | Splenic marginal zone lymphoma | Use when the lymphoma is primarily affecting the spleen with the specified clinical features. |
|
| C88.4 | Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma) | Use when the lymphoma is extranodal, particularly in mucosal sites like the stomach. |
|
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 marginal zone lymphoma
Essential facts and insights about Marginal Zone Lymphoma
Primary ICD-10-CM Codes for marginal zone lymphoma
Decision Criteria
clinical Criteria
- Presence of splenomegaly and specific immunophenotype
Applicable To
- Splenic MZL
Excludes
- Extranodal MALT lymphoma (C88.4)
Clinical Validation Requirements
- Splenomegaly with circulating villous lymphocytes
- CD5-, CD10-, cyclin D1- by flow cytometry
- NOTCH2 mutation detected
Code-Specific Risks
- Confusing with other small B-cell lymphomas
- Incorrectly coding as C83.0
Coding Notes
- Ensure documentation specifies splenic involvement and excludes nodal or extranodal disease.
C88.4 - Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma)
Use when the lymphoma is extranodal, particularly in mucosal sites like the stomach.
Applicable To
- MALT lymphoma
Excludes
- Splenic marginal zone lymphoma (C85.87)
Clinical Validation Requirements
- Lymphoepithelial lesions with centrocyte-like cells
- t(11;18) translocation confirmed by FISH
- No evidence of nodal disease
Coding Notes
Ensure documentation specifies the extranodal site and confirms the absence of nodal disease.
Differential 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 Marginal Zone Lymphoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C85.87.
Impact
Clinical: Leads to inappropriate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Always document the primary site of lymphoma., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect DRG assignment leading to incorrect reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use C85.87 for splenic marginal zone lymphoma.
Impact
Using outdated or incorrect codes for marginal zone lymphoma.
Mitigation Strategy
Regular training and updates on coding guidelines.
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 Marginal Zone Lymphoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Marginal Zone Lymphoma
Use these documentation templates to ensure complete and accurate documentation for Marginal Zone Lymphoma. These templates include all required elements for proper coding and billing.
Extranodal MALT Lymphoma Diagnosis
Specialty: OncologyRequired Elements
- Patient history
- Endoscopic findings
- Pathology report
- Immunophenotyping results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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