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《ICD-10-CM官(Guan)方(Fang)指(Zhi)南(Nan)》中(Zhong)恶(E)性(Xing)肿(Zhong)瘤(Liu)主(Zhu)要(Yao)诊(Zhen)断(Duan)选(Xuan)择(Ze)相(Xiang)关(Guan)内(Nei)容(Rong)（四(Si)）原(Yuan)创(Chuang)2023-08-08 09:48·DRG打(Da)工(Gong)人(Ren)前(Qian)言(Yan)ICD-10-CM Official Guidelines for Coding and Reporting FY 2023中(Zhong)恶(E)性(Xing)肿(Zhong)瘤(Liu)主(Zhu)要(Yao)诊(Zhen)断(Duan)选(Xuan)择(Ze)的(De)相(Xiang)关(Guan)描(Miao)述(Shu)翻(Fan)译(Yi)系(Xi)列(Lie)文(Wen)章(Zhang):《ICD-10-CM编(Bian)码(Ma)和(He)报(Bao)告(Gao)的(De)官(Guan)方(Fang)指(Zhi)南(Nan)》中(Zhong)恶(E)性(Xing)肿(Zhong)瘤(Liu)主(Zhu)要(Yao)诊(Zhen)断(Duan)选(Xuan)择(Ze)相(Xiang)关(Guan)内(Nei)容(Rong)（一(Yi)）：翻(Fan)译(Yi)第(Di)一(Yi)~三(San)大(Da)条(Tiao)《ICD-10-CM编(Bian)码(Ma)和(He)报(Bao)告(Gao)的(De)官(Guan)方(Fang)指(Zhi)南(Nan)》中(Zhong)恶(E)性(Xing)肿(Zhong)瘤(Liu)主(Zhu)要(Yao)诊(Zhen)断(Duan)选(Xuan)择(Ze)相(Xiang)关(Guan)内(Nei)容(Rong)（二(Er)）：翻(Fan)译(Yi)第(Di)四(Si)~七(Qi)大(Da)条(Tiao)《ICD-10-CM编(Bian)码(Ma)和(He)报(Bao)告(Gao)的(De)官(Guan)方(Fang)指(Zhi)南(Nan)》中(Zhong)恶(E)性(Xing)肿(Zhong)瘤(Liu)主(Zhu)要(Yao)诊(Zhen)断(Duan)选(Xuan)择(Ze)相(Xiang)关(Guan)内(Nei)容(Rong)（三(San)）：翻(Fan)译(Yi)第(Di)八(Ba)~十(Shi)二(Er)大(Da)条(Tiao)本(Ben)期(Qi)翻(Fan)译(Yi)第(Di)十(Shi)三(San)~十(Shi)四(Si)大(Da)条(Tiao)。l. Sequencing of neoplasm codes肿(Zhong)瘤(Liu)编(Bian)码(Ma)排(Pai)序(Xu)1) Encounter for treatment of primary malignancy因(Yin)治(Zhi)疗(Liao)原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)而(Er)就(Jiu)诊(Zhen)If the reason for the encounter is for treatment of a primary malignancy, assign the malignancy as the principal/first-listed diagnosis. The primary site is to be sequenced first, followed by any metastatic sites.如(Ru)果(Guo)就(Jiu)诊(Zhen)原(Yuan)因(Yin)是(Shi)治(Zhi)疗(Liao)原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)，则(Ze)将(Jiang)恶(E)性(Xing)肿(Zhong)瘤(Liu)作(Zuo)为(Wei)主(Zhu)要(Yao)/第(Di)一(Yi)诊(Zhen)断(Duan)。首(Shou)先(Xian)对(Dui)原(Yuan)发(Fa)部(Bu)位(Wei)进(Jin)行(Xing)排(Pai)序(Xu)，然(Ran)后(Hou)是(Shi)任(Ren)何(He)转(Zhuan)移(Yi)部(Bu)位(Wei)。2) Encounter for treatment of secondary malignancy因(Yin)治(Zhi)疗(Liao)继(Ji)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)而(Er)就(Jiu)诊(Zhen)When an encounter is for a primary malignancy with metastasis and treatment is directed toward the metastatic (secondary) site(s) only, the metastatic site(s) is designated as the principal/first-listed diagnosis. The primary malignancy is coded as an additional code.如(Ru)果(Guo)就(Jiu)诊(Zhen)原(Yuan)因(Yin)是(Shi)原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)伴(Ban)转(Zhuan)移(Yi)，而(Er)治(Zhi)疗(Liao)仅(Jin)针(Zhen)对(Dui)转(Zhuan)移(Yi)（继(Ji)发(Fa)）部(Bu)位(Wei)，则(Ze)转(Zhuan)移(Yi)部(Bu)位(Wei)作(Zuo)为(Wei)主(Zhu)要(Yao)/第(Di)一(Yi)诊(Zhen)断(Duan)。原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)作(Zuo)为(Wei)附(Fu)加(Jia)编(Bian)码(Ma)。3) Malignant neoplasm in a pregnant patient妊(Ren)娠(Shen)合(He)并(Bing)恶(E)性(Xing)肿(Zhong)瘤(Liu)When a pregnant patient has a malignant neoplasm, a code from subcategory O9A.1-, Malignant neoplasm complicating pregnancy, childbirth, and the puerperium, should be sequenced first, followed by the appropriate code from Chapter 2 to indicate the type of neoplasm.当(Dang)妊(Ren)娠(Shen)患(Huan)者(Zhe)患(Huan)有(You)恶(E)性(Xing)肿(Zhong)瘤(Liu)时(Shi)，应(Ying)首(Shou)先(Xian)使(Shi)用(Yong) O9A.1- "妊(Ren)娠(Shen)、分(Fen)娩(Mian)和(He)产(Chan)褥(Ru)期(Qi)并(Bing)发(Fa)恶(E)性(Xing)肿(Zhong)瘤(Liu) "中(Zhong)的(De)编(Bian)码(Ma)，然(Ran)后(Hou)使(Shi)用(Yong)第(Di) 2 章(Zhang)中(Zhong)的(De)适(Shi)当(Dang)编(Bian)码(Ma)来(Lai)表(Biao)示(Shi)肿(Zhong)瘤(Liu)类(Lei)型(Xing)。4) Encounter for complication associated with a neoplasm因(Yin)肿(Zhong)瘤(Liu)并(Bing)发(Fa)症(Zheng)而(Er)就(Jiu)诊(Zhen)When an encounter is for management of a complication associated with a neoplasm, such as dehydration, and the treatment is only for the complication, the complication is coded first, followed by the appropriate code(s) for the neoplasm.如(Ru)果(Guo)就(Jiu)诊(Zhen)原(Yuan)因(Yin)是(Shi)为(Wei)了(Liao)治(Zhi)疗(Liao)与(Yu)肿(Zhong)瘤(Liu)相(Xiang)关(Guan)的(De)并(Bing)发(Fa)症(Zheng)（如(Ru)脱(Tuo)水(Shui)），且(Qie)治(Zhi)疗(Liao)仅(Jin)针(Zhen)对(Dui)并(Bing)发(Fa)症(Zheng)，则(Ze)先(Xian)对(Dui)并(Bing)发(Fa)症(Zheng)进(Jin)行(Xing)编(Bian)码(Ma)，然(Ran)后(Hou)再(Zai)对(Dui)肿(Zhong)瘤(Liu)进(Jin)行(Xing)适(Shi)当(Dang)编(Bian)码(Ma)。The exception to this guideline is anemia. When the admission/encounter is for management of an anemia associated with the malignancy, and the treatment is only for anemia, the appropriate code for the malignancy is sequenced as the principal or first-listed diagnosis followed by code D63.0, Anemia in neoplastic disease.贫(Pin)血(Xue)是(Shi)本(Ben)指(Zhi)南(Nan)的(De)例(Li)外(Wai)情(Qing)况(Kuang)。如(Ru)果(Guo)入(Ru)院(Yuan)/就(Jiu)诊(Zhen)是(Shi)为(Wei)了(Liao)治(Zhi)疗(Liao)与(Yu)恶(E)性(Xing)肿(Zhong)瘤(Liu)相(Xiang)关(Guan)的(De)贫(Pin)血(Xue)，且(Qie)治(Zhi)疗(Liao)仅(Jin)针(Zhen)对(Dui)贫(Pin)血(Xue)，则(Ze)应(Ying)将(Jiang)恶(E)性(Xing)肿(Zhong)瘤(Liu)的(De)相(Xiang)应(Ying)编(Bian)码(Ma)作(Zuo)为(Wei)主(Zhu)要(Yao)诊(Zhen)断(Duan)或(Huo)第(Di)一(Yi)诊(Zhen)断(Duan)，然(Ran)后(Hou)是(Shi)编(Bian)码(Ma) D63.0 "肿(Zhong)瘤(Liu)性(Xing)疾(Ji)病(Bing)中(Zhong)的(De)贫(Pin)血(Xue)"。5) Complication from surgical procedure for treatment of a neoplasm治(Zhi)疗(Liao)肿(Zhong)瘤(Liu)的(De)手(Shou)术(Shu)并(Bing)发(Fa)症(Zheng)When an encounter is for treatment of a complication resulting from a surgical procedure performed for the treatment of the neoplasm, designate the complication as the principal/first-listed diagnosis. See the guideline regarding the coding of a current malignancy versus personal history to determine if the code for the neoplasm should also be assigned.如(Ru)果(Guo)就(Jiu)诊(Zhen)是(Shi)为(Wei)了(Liao)治(Zhi)疗(Liao)肿(Zhong)瘤(Liu)而(Er)进(Jin)行(Xing)的(De)外(Wai)科(Ke)手(Shou)术(Shu)所(Suo)引(Yin)起(Qi)的(De)并(Bing)发(Fa)症(Zheng)，则(Ze)应(Ying)将(Jiang)并(Bing)发(Fa)症(Zheng)指(Zhi)定(Ding)为(Wei)主(Zhu)要(Yao)/第(Di)一(Yi)诊(Zhen)断(Duan)。请(Qing)参(Can)阅(Yue)有(You)关(Guan)当(Dang)前(Qian)恶(E)性(Xing)肿(Zhong)瘤(Liu)与(Yu)个(Ge)人(Ren)病(Bing)史(Shi)的(De)编(Bian)码(Ma)指(Zhi)南(Nan)，以(Yi)确(Que)定(Ding)是(Shi)否(Fou)也(Ye)应(Ying)分(Fen)配(Pei)肿(Zhong)瘤(Liu)的(De)编(Bian)码(Ma)。6) Pathologic fracture due to a neoplasm肿(Zhong)瘤(Liu)导(Dao)致(Zhi)的(De)病(Bing)理(Li)性(Xing)骨(Gu)折(Zhe)When an encounter is for a pathological fracture due to a neoplasm, and the focus of treatment is the fracture, a code from subcategory M84.5, Pathological fracture in neoplastic disease, should be sequenced first, followed by the code for the neoplasm.如(Ru)果(Guo)就(Jiu)诊(Zhen)原(Yuan)因(Yin)是(Shi)因(Yin)肿(Zhong)瘤(Liu)导(Dao)致(Zhi)的(De)病(Bing)理(Li)性(Xing)骨(Gu)折(Zhe)，且(Qie)治(Zhi)疗(Liao)重(Zhong)点(Dian)是(Shi)骨(Gu)折(Zhe)，则(Ze)应(Ying)首(Shou)先(Xian)使(Shi)用(Yong) M84.5（肿(Zhong)瘤(Liu)性(Xing)疾(Ji)病(Bing)中(Zhong)的(De)病(Bing)理(Li)性(Xing)骨(Gu)折(Zhe)）中(Zhong)的(De)编(Bian)码(Ma)，然(Ran)后(Hou)再(Zai)使(Shi)用(Yong)肿(Zhong)瘤(Liu)的(De)编(Bian)码(Ma)。If the focus of treatment is the neoplasm with an associated pathological fracture, the neoplasm code should be sequenced first, followed by a code from M84.5 for the pathological fracture.如(Ru)果(Guo)治(Zhi)疗(Liao)重(Zhong)点(Dian)是(Shi)伴(Ban)有(You)病(Bing)理(Li)骨(Gu)折(Zhe)的(De)肿(Zhong)瘤(Liu)，则(Ze)应(Ying)首(Shou)先(Xian)使(Shi)用(Yong)肿(Zhong)瘤(Liu)编(Bian)码(Ma)，然(Ran)后(Hou)使(Shi)用(Yong) M84.5 中(Zhong)的(De)病(Bing)理(Li)骨(Gu)折(Zhe)编(Bian)码(Ma)。m. Current malignancy versus personal history of malignancy当(Dang)前(Qian)恶(E)性(Xing)肿(Zhong)瘤(Liu)与(Yu)个(Ge)人(Ren)恶(E)性(Xing)肿(Zhong)瘤(Liu)史(Shi)When a primary malignancy has been excised but further treatment, such as an additional surgery for the malignancy, radiation therapy or chemotherapy is directed to that site, the primary malignancy code should be used until treatment is completed.如(Ru)果(Guo)原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)已(Yi)被(Bei)切(Qie)除(Chu)，但(Dan)仍(Reng)需(Xu)进(Jin)一(Yi)步(Bu)治(Zhi)疗(Liao)，如(Ru)针(Zhen)对(Dui)该(Gai)部(Bu)位(Wei)的(De)额(E)外(Wai)恶(E)性(Xing)肿(Zhong)瘤(Liu)手(Shou)术(Shu)、放(Fang)疗(Liao)或(Huo)化(Hua)疗(Liao)，则(Ze)应(Ying)使(Shi)用(Yong)原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)编(Bian)码(Ma)，直(Zhi)至(Zhi)治(Zhi)疗(Liao)结(Jie)束(Shu)。When a primary malignancy has been previously excised or eradicated from its site, there is no further treatment (of the malignancy) directed to that site, and there is no evidence of any existing primary malignancy at that site, a code from category Z85, Personal history of malignant neoplasm, should be used to indicate the former site of the malignancy.当(Dang)原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)先(Xian)前(Qian)已(Yi)从(Cong)其(Qi)部(Bu)位(Wei)切(Qie)除(Chu)或(Huo)根(Gen)除(Chu)，没(Mei)有(You)针(Zhen)对(Dui)该(Gai)部(Bu)位(Wei)的(De)（恶(E)性(Xing)肿(Zhong)瘤(Liu)）进(Jin)一(Yi)步(Bu)治(Zhi)疗(Liao)，且(Qie)没(Mei)有(You)证(Zheng)据(Ju)表(Biao)明(Ming)该(Gai)部(Bu)位(Wei)存(Cun)在(Zai)任(Ren)何(He)原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)时(Shi)，应(Ying)使(Shi)用(Yong) Z85（个(Ge)人(Ren)恶(E)性(Xing)肿(Zhong)瘤(Liu)病(Bing)史(Shi)）中(Zhong)的(De)编(Bian)码(Ma)来(Lai)表(Biao)示(Shi)恶(E)性(Xing)肿(Zhong)瘤(Liu)的(De)原(Yuan)发(Fa)部(Bu)位(Wei)。Codes from subcategories Z85.0 – Z85.85 should only be assigned for the former site of a primary malignancy, not the site of a secondary malignancy. Code Z85.89 may be assigned for the former site(s) of either a primary or secondary malignancy.Z85.0-Z85.85 子(Zi)类(Lei)别(Bie)中(Zhong)的(De)编(Bian)码(Ma)只(Zhi)能(Neng)用(Yong)于(Yu)原(Yuan)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)的(De)原(Yuan)发(Fa)部(Bu)位(Wei)，而(Er)不(Bu)能(Neng)用(Yong)于(Yu)继(Ji)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)的(De)原(Yuan)发(Fa)部(Bu)位(Wei)。编(Bian)码(Ma) Z85.89 可(Ke)用(Yong)于(Yu)原(Yuan)发(Fa)性(Xing)或(Huo)继(Ji)发(Fa)性(Xing)恶(E)性(Xing)肿(Zhong)瘤(Liu)的(De)原(Yuan)发(Fa)部(Bu)位(Wei)。
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