2025 ICD-10-CM code C76.0

Malignant neoplasm of head, face, and neck. This code designates a primary malignant neoplasm when the specific site within the head, face, and neck region is not specified.

Use this code only when the primary site cannot be identified within the head, face, and neck. If the site overlaps contiguous areas, refer to specific guidelines for coding overlapping lesions.

Medical necessity must be established for all diagnostic and treatment procedures related to the malignant neoplasm.The documentation must support the need for the services provided, linking them to the diagnosis and treatment plan.

The provider is responsible for diagnosing the condition through physical examination, imaging tests (X-rays, CT scans, MRI, PET), and biopsies. Treatment may involve surgery, chemotherapy, radiation therapy, or targeted therapy depending on the cancer's stage and type.

IMPORTANT If the specific site is known, use the appropriate code for that location (e.g., C00-C75). If the neoplasm is a secondary malignancy, use codes C77-C79.Refer to the iFrameAI product for detailed guidelines and accurate coding.

In simple words: Cancer in the head, face, or neck area, but the exact location is unclear.

Malignant neoplasm of head, face, and neck, unspecified site. This code encompasses cases where a malignant tumor originates within the head, face, or neck region but further specification of the anatomical location (e.g., cheek, nose) is not documented or available.

Example 1: A patient presents with a neck lump and undergoes a biopsy that reveals a malignant neoplasm. The pathologist is unable to determine the tumor's precise origin within the head and neck region. C76.0 is used., A patient with a history of throat discomfort undergoes an examination. A malignant tumor is discovered, but its exact anatomical location cannot be determined. C76.0 is applied., Imaging reveals a mass in the facial area, and subsequent biopsy confirms it as malignant.However, the documentation does not pinpoint the primary site within the face. C76.0 is assigned.

Documentation should include biopsy reports, imaging findings, physical exam notes, and any relevant clinical details supporting the diagnosis of malignancy. Precise anatomical location of the primary tumor should be described if known, which may lead to a more specific code assignment than C76.0.

  • Specialties:Oncology, Head and Neck Surgery, Otolaryngology, Radiation Oncology
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office,Independent Clinic
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