Eye Cancer ICD 10 Code

Refresher: What are ICD-10 codes?

ICD-10 codes play an important role in the classification of diseases, injuries, and all types of cancers. Healthcare officials in the US, including nurses, physicians, and medical coders, among others, rely on these codes to improve patient diagnosis, treatment, and outcomes. The most recent edition of the codes is known as ICD-10 [¹].

These codes are passed to insurance companies for billing purposes. There are over 68,000 of these codes with highly specific definitions [²]. Most patients will encounter ICD-10 codes on paperwork and bills, but understanding them can be quite important, especially when it comes to coverage and getting medical pre-approval.

You may have also come across the ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification). This system is a clinical modification of the ICD-10, but in essence, there is no difference between the codes because they refer to the same set of diagnostic codes used by healthcare professionals throughout the US.

Note that ICD-10 PCS is a different set of codes that are used for inpatient settings. Using the coding system outside inpatient settings may be inaccurate. ICD-10 codes can also be used for the classification of secondary or metastasized tumors (secondary malignant neoplasms) [³].

Rare diseases like eye cancer often require accurate diagnostic tools for early detection and treatment. Most types of eye cancers can be incredibly aggressive, although the five-year relative survival rate for the disease is relatively high at 80% in the US. This article takes a look at the ICD-10 code for eye cancers.

What is the ICD 10 code for Eye Cancer?

For primary eye cancer tumors, the general ICD-10 code is C69 (malignant neoplasm of eye and adnexa), with several codes. Note that codes under C69 do not include malignant neoplasm of the eyelid (classified under C43 and C44), the connective tissue of the eyelid (C49), and the optic nerve (C72).

For example, orbital tumors (characterized by abnormal tissue growths surrounding the eye) are coded under ICD-69. These malignant lesions mostly arise from the orbit but can metastasize elsewhere in the body.

ICD-10 C69 also covers ciliary cancer, an extremely rare type of tumor. At first, they appear to be asymptomatic with a small pigment. A very small subset of the population encounters ciliary cancer, making it difficult to classify the cancerous tumors.

Conjunctival tumors are also classified under ICD-10 C69, with the most common being malignant melanoma, lymphoma, and squamous cell carcinoma. These salmon-colored tumors manifest as red patches on the eye. Eye cancer specialists will use a biopsy so that a pathologist can perform studies on the tumor cells.

Malignant Neoplasm of Eye ICD 10 code: C69

Primary Eye Cancer ICD code C69 lookup

Below is a table of the ICD 10 {cancer type} codes for primary eye cancers, which are classified under C69, “malignant neoplasm of eye and adnexa” [⁴].

C69: Malignant neoplasm of Eye Cancer

Types of eye cancer coded under C69

Further exploration of C69 codes can reveal more details about the specific eye that has been affected and any overlapping sites. Below are a few examples of common types of eye cancer that are covered under C69:

• Malignant neoplasm of the retina
• Cancer of the ciliary body
• Cancer of the orbit
• Cancer of the conjunctiva

In other words, eye cancer ICD 10, malignant neoplasm of the eye ICD 10, and malignant neoplasm of the eye and adnexa ICD 10 codes could all be C69 if they are determined to be primary malignant neoplasm of the eye. As a concrete example, a patient diagnosed with malignant neoplasm of overlapping sites of the right eye and adnexa would be coded with 69.81.

When compared to ICD-9, ICD-10 adds more detail to how a patient’s eye cancer is coded.

For example, tumors of the orbit may simply be classified as “malignant neoplasm of orbit” in ICD-9, whereas in ICD-10, the cancer can be coded as “malignant neoplasm of the left orbit”. This increased specificity has clear advantages in the treatment of the disease, especially when the patient undergoes treatment under different physicians.

It is important for their medical histories to be stored in a consistent and organized manner so that other healthcare providers know that it was the left orbital that has cancer and not the lacrimal gland.

With that said, there are a few clear disadvantages of ICD-10 69. For example, computer systems in healthcare organizations would need to be updated from ICD-9 (or completely changed in some cases). This will be a separate charge by service providers. Consequently, healthcare professionals and medical coders will have to upgrade their certifications, which means attending more seminars and classes, which can be very costly. Taking the exam itself can also be expensive.

Switching to ICD-10 69 will also require doctors to reformat the billing from ICD-9, which can take quite some time for healthcare providers to get used to. Healthcare organizations with a smaller budget may struggle to accommodate these procedures and encounter a loss of productivity. Moreover, the increased specificity demanded by the ICD-10 69 code may require huge volumes of data for higher accuracy. For example, if the medical coder miscodes cancer of the left orbital, whereas the patient had cancer of the right orbital, future healthcare providers will run the risk of relying on the original, erroneous coding.

A major risk of inaccurate coding is that even a single accuracy in the digit could lead to a different diagnosis than what the patient has. This may result in the denial of healthcare insurance because of a type of cancer they don’t have.

Eye cancers excluded from ICD-10 C69

Malignant neoplasm of the eye and adnexa C69 exclude the following types of eye cancer:

• Malignant neoplasm of the skin of the eyelid (covered under C43.1 and C44.1)
• Malignant neoplasm of the connective tissue of the eyelid (C49.0)
• Malignant neoplasm of the optic nerve (C72.3)

It is worth mentioning that the most common types of eye cancers, including eye melanoma and squamous cell carcinoma, are all excluded from C69. Most of these eye cancers have similar symptoms despite their different coding systems) including blurred vision, flashes of light, and bulging of the eye).

It is important to get these symptoms checked by a doctor at the earliest for accurate diagnosis.

Conclusion

The ICD 10 code for eye cancers depends on the specific location of the primary neoplasm and whether it affects the ciliary body, orbit, conjunctiva, or retina. Primary eye cancer falls under ICD-10 C69, but it does not include the cancer of the eyelid.

All the information contained in this article may only be used for reference purposes and does not replace professional advice from a healthcare professional. If you experience any of the symptoms of eye cancer, please visit your doctor for any health-related questions, including the ICD-10 codes discussed here.