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).
MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED SITES (190-199)
Excludes:
carcinoma in situ (234.0-234.9)
Excludes:
carcinoma in situ (234.0)
dark area on retina and choroid (239.81)
malignant melanoma of eyelid (skin) (172.1)
cartilage (171.0)
malignant neoplasm of eyelid (skin) (173.10-173.19)
optic nerve (192.0)
orbital bone (170.0)
retinal freckle (239.81)
Excludes:
cranial nerves (192.0)
retrobulbar area (190.1)
Excludes:
peripheral, sympathetic, and parasympathetic nerves and ganglia (171.0-171.9)
Thyroglossal duct
Use additional code to identify any functional activity
Excludes:
islets of Langerhans (157.4)
neuroendocrine tumors (209.00-209.69)
ovary (183.0)
testis (186.0-186.9)
thymus (164.0)
Includes:
malignant neoplasms of contiguous sites, not elsewhere classified, whose point of origin cannot be determined
Excludes:
malignant neoplasm:
lymphatic and hematopoietic tissue (200.0-208.9)
secondary sites (196.0-198.8)
unspecified site (199.0-199.1)
Excludes:
any malignant neoplasm of lymph nodes, specified as primary (200.0-202.9)
Hodgkin's disease (201.0-201.9)
lymphosarcoma (200.1)
reticulosarcoma (200.0)
other forms of lymphoma (202.0-202.9)
secondary neuroendocrine tumor of (distant) lymph nodes (209.71)
Excludes:
lymph node metastasis (196.0-196.9)
secondary neuroendocrine tumor of liver (209.72)
secondary neuroendocrine tumor of respiratory organs (209.79)
Excludes:
lymph node metastasis (196.0-196.9)
secondary neuroendocrine tumor of other specified sites (209.79)
Excludes:
malignant carcinoid tumor of unknown primary site (209.20)
malignant (poorly differentiated) neuroendocrine carcinoma, any site (209.30)
malignant (poorly differentiated) neuroendocrine tumor, any site (209.30)
neuroendocrine carcinoma (high grade), any site (209.30)

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