February 28, 2007

ACR Radiology Coding Source January-February 2007 Q and A

We are struggling with ICD-10 and the assignment of codes to describe a lung mass, nodule and lesion. Are these terms interchangeable? If singular, is it considered a solitary lung nodule – R91.1? If the documentation states lung mass, is that the equivalent of a solitary lung nodule?

In response to an ACR request to the American Hospital Association (AHA)* for clarification on the reporting of single or multiple lung masses, nodules or lesions, the AHA advised that the coding professional should follow the cross-references under the main term in the Alphabetic Index representing the documented diagnosis. For example, lung mass and multiple lung nodules are specifically indexed to code R91.8, Other nonspecific abnormal finding of lung field. However, lung lesion is indexed to R91.1, Solitary pulmonary nodule. These codes all pertain to abnormal findings on diagnostic imaging of the lung when documented by the physician.

*The AHA is one of the four organizations (AHA, the American Health Information Management Association (AHIMA), the Centers for Medicare and Medicaid Services, and National Center for Health Statistics that make up the Cooperating Parties for the ICD-10-CM: and responsible for approving the

*The AHA is one of the four organizations (AHA, the American Health Information Management Association (AHIMA), the Centers for Medicare and Medicaid Services, and National Center for Health Statistics that make up the Cooperating Parties for the ICD-10-CM: and responsible for approving the official guidelines.