2. NEOPLASMS (140-239)
1. Content:
This chapter contains the following broad groups:
140-195 Malignant neoplasms, stated or presumed to be primary, of specified sites, except of lymphatic and hematopoietic tissue
196-198 Malignant neoplasms, stated or presumed to be secondary, of specified sites
199 Malignant neoplasms, without specification of site
200-208 Malignant neoplasms, stated or presumed to be primary, of lymphatic and hematopoietic tissue
209 Neuroendocrine tumors
210-229 Benign neoplasms
230-234 Carcinoma in situ
235-238 Neoplasms of uncertain behavior [see Note, at beginning of section 235-238]
239 Neoplasms of unspecified nature
2. Functional activity
All neoplasms are classified in this chapter, whether or not functionally active. An additional code from Chapter 3 may be used to identify such functional activity associated with any neoplasm, e.g.:
catecholamine-producing malignant pheochromocytoma of adrenal:
code 194.0, additional code 255.6
basophil adenoma of pituitary with Cushing's syndrome:
code 227.3, additional code 255.0
3. Morphology [Histology]
For those wishing to identify the histological type of neoplasms, a comprehensive coded nomenclature, which comprises the morphology rubrics of the ICD-Oncology, is given after the E-code chapter.
4. Malignant neoplasms overlapping site boundaries
Categories 140-195 are for the classification of primary malignant neoplasms according to their point of origin. A malignant neoplasm that overlaps two or more subcategories within a three-digit rubric and whose point of origin cannot be determined should be classified to the subcategory .8 "Other." For example, "carcinoma involving tip and ventral surface of tongue" should be assigned to 141.8. On the other hand, "carcinoma of tip of tongue, extending to involve the ventral surface" should be coded to 141.2, as the point of origin, the tip, is known. Three subcategories (149.8, 159.8, 165.8) have been provided for malignant neoplasms that overlap the boundaries of three-digit rubrics within certain systems. Overlapping malignant neoplasms that cannot be classified as indicated above should be assigned to the appropriate subdivision of category 195 (Malignant neoplasm of other and ill-defined sites).
carcinoma in situ:
breast (233.0)
skin (232.0-232.9)
carcinoma in situ (233.1-233.9)
carcinoma in situ (234.0-234.9)
autoimmune lymphoproliferative syndrome (279.41)
secondary neoplasm of:
bone marrow (198.5)
spleen (197.8)
secondary and unspecified neoplasm of lymph nodes (196.0-196.9)
The following fifth-digit subclassification is for use with categories 200-202:
0 unspecified site, extranodal and solid organ sites
1 lymph nodes of head, face, and neck
2 intrathoracic lymph nodes
3 intra-abdominal lymph nodes
4 lymph nodes of axilla and upper limb
5 lymph nodes of inguinal region and lower limb
6 intrapelvic lymph nodes
7 spleen
8 lymph nodes of multiple sites
Bowen's disease
Queyrat's erythroplasia
leukoplakia - see Alphabetic Index
Categories 235-238 classify by site certain histo-morphologically well-defined neoplasms, the subsequent behavior of which cannot be predicted from the present appearance.