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General Surgery Coding Alert


1 Code for Malignant Tonsil? - Not Any More

Don’t forget additional code.

You’ve had it pretty easy up until now — reporting a malignant tonsil with just one code: 146.0 (Malignant neoplasm of tonsil).

You can forget about easy when ICD-10 goes into effect October 1 this year, because you’ll need to select from four malignant tonsil codes, plus choose a code from a host of additional codes that you must report secondarily.

Learn the Choices:

ICD-9 specifies that 146.0 is for tonsil, faucial, palatine, or not otherwise specified (NOS), and directs you to different codes for lingual or pharyngeal tonsil.

ICD-10 makes the same distinctions — and then some. Instead of one code for the palatine tonsils, you have the following choices:

  • C09.0 — Malignant neoplasm of tonsillar fossa
  • C09.1 — Malignant neoplasm of tonsillar pillar (anterior) (posterior)
  • C09.8 — Malignant neoplasm of overlapping sites of tonsil
  • C09.9 — Malignant neoplasm of tonsil, unspecified.

That’s not all: ICD-10 also instructs you to use an additional code from the following list, if applicable, which you should report second:

  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22) 
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco use (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0).