C40.20
BillableMalignant neoplasm of long bones of unspecified lower limb
Chapter 2: Neoplasms
Additional Information
From parent codes: C00-D49 (Chapter 2)
NotesFrom C00-D49
Additional notes from parent codes that apply to this code.
- Functional activity
- All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
- Morphology [Histology]
- Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
- Primary malignant neoplasms overlapping site boundaries
- A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
- Malignant neoplasm of ectopic tissue
- Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).
Inpatient DRG Payments
DRG 5438,898 discharges
Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc
Avg. Medicare Payment
$8,054
Total Payment$10,379
Patient Responsibility$2,325
Hospital Charge$49,225
DRG 5423,536 discharges
Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Mcc
Avg. Medicare Payment
$15,129
Total Payment$18,732
Patient Responsibility$3,604
Hospital Charge$89,227
DRG 544467 discharges
Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy Without Cc/m
Avg. Medicare Payment
$4,937
Total Payment$6,558
Patient Responsibility$1,622
Hospital Charge$35,633
Chapter Information