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AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2023 Issue 1; Ask the Editor

Diffuse Large B Cell Lymphoma with Metastasis

The patient was recently diagnosed with aggressive, diffuse large B-cell lymphoma in multiple lymphatic sites involving lymph nodes of the right hilum, right iliac and right paracolic gutter areas as well metastasis to the lung, brain and left adrenal gland. How should we report metastatic sites in a patient with lymphoma? Does the 5th character “9,” “Extranodal and other solid organ sites” capture metastatic sites outside of the lymphatic system or should each non-hematopoietic metastatic site be reported separately with codes from categories C78, Secondary malignant neoplasm of respiratory and digestive organs, and/or C79, Secondary malignant neoplasm of other and unspecified sites? What are the appropriate codes for diffuse large B-cell lymphoma involving lymph nodes of multiple sites with metastases to the lung, brain and left adrenal gland? ...

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