2. NEOPLASMS (ICD 9 CODES: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).
MALIGNANT NEOPLASM OF LIP, ORAL CAVITY, AND PHARYNX (140-149)
Excludes: carcinoma in situ (230.0)
Excludes: malignant melanoma of skin of lip (172.0)
malignant neoplasm of skin of lip (173.00-173.09)
Upper lip:
NOS
external
lipstick area
Lower lip:
NOS
external
lipstick area
Upper lip:
buccal aspect
frenulum
mucosa
oral aspect
Lower lip:
buccal aspect
frenulum
mucosa
oral aspect
Lip, not specified whether upper or lower:
buccal aspect
frenulum
mucosa
oral aspect
Labial commissure
Malignant neoplasm of contiguous or overlapping sites of lip whose point of origin cannot be determined
Lip, not specified as upper or lower:
NOS
external
lipstick area
Dorsal surface of base of tongue
Fixed part of tongue NOS
Anterior two-thirds of tongue, dorsal surface
Dorsal tongue NOS
Midline of tongue
Excludes: dorsal surface of base of tongue (141.0)
Anterior two-thirds of tongue, ventral surface
Frenulum linguae
Mobile part of tongue NOS
Border of tongue at junction of fixed and mobile parts at insertion of anterior tonsillar pillar
Malignant neoplasm of contiguous or overlapping sites of tongue whose point of origin cannot be determined
Tongue NOS
Includes: salivary ducts
Excludes: malignant neoplasm of minor salivary glands:
NOS (145.9)
buccal mucosa (145.0)
soft palate (145.3)
tongue (141.0-141.9)
tonsil, palatine (146.0)
Submaxillary gland
Malignant neoplasm of contiguous or overlapping sites of salivary glands and ducts whose point of origin cannot be determined
Salivary gland (major) NOS
Includes: alveolar (ridge) mucosa
gingiva (alveolar) (marginal)
interdental papillae
Excludes: malignant odontogenic neoplasms (170.0-170.1)
Malignant neoplasm of contiguous or overlapping sites of gum whose point of origin cannot be determined
Anterior to the premolar-canine junction
Malignant neoplasm of contiguous or overlapping sites of floor of mouth whose point of origin cannot be determined
Excludes: mucosa of lips (140.0-140.9)
Buccal mucosa
Cheek, inner aspect
Buccal sulcus (upper) (lower)
Labial sulcus (upper) (lower)
Excludes: nasopharyngeal [posterior] [superior] surface of soft palate (147.3)
Junction of hard and soft palate
Roof of mouth
Malignant neoplasm of contiguous or overlapping sites of mouth whose point of origin cannot be determined
Buccal cavity NOS
Minor salivary gland, unspecified site
Oral cavity NOS
Tonsil:
NOS
faucial
palatine
Excludes: lingual tonsil (141.6)
pharyngeal tonsil (147.1)
Faucial pillar
Glossopalatine fold
Palatoglossal arch
Palatopharyngeal arch
Anterior and medial surface of the pharyngoepiglottic fold
Epiglottis, free border [margin]
Glossoepiglottic fold(s)
Excludes: epiglottis:
NOS (161.1)
suprahyoid portion (161.1)
Junction of the free margin of the epiglottis, the aryepiglottic fold, and the pharyngoepiglottic fold
Branchial cleft
Malignant neoplasm of contiguous or overlapping sites of oropharynx whose point of origin cannot be determined
Roof of nasopharynx
Adenoid
Pharyngeal tonsil
Fossa of Rosenmüller
Opening of auditory tube
Pharyngeal recess
Floor of nasopharynx
Nasopharyngeal [posterior] [superior] surface of soft palate
Posterior margin of nasal septum and choanae
Malignant neoplasm of contiguous or overlapping sites of nasopharynx whose point of origin cannot be determined
Nasopharyngeal wall NOS
Pyriform fossa
Aryepiglottic fold or interarytenoid fold:
NOS
marginal zone
Excludes: aryepiglottic fold or interarytenoid fold, laryngeal aspect (161.1)
Malignant neoplasm of contiguous or overlapping sites of hypopharynx whose point of origin cannot be determined
Hypopharyngeal wall NOS
Hypopharynx NOS
Malignant neoplasms of lip, oral cavity, and pharynx whose point of origin cannot be assigned to any one of the categories 140-148
Excludes: "book leaf" neoplasm [ventral surface of tongue and floor of mouth] (145.8)
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