Morphology Codes — What Are They Used For?

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Q: What in the world are these morphology codes? What are they used for? I don’t see them in any of my coding materials. None of my class work covers them. Nobody seems to use them but they are prominent in the ICD Index and there is a whole appendix all about them.

A: I will admit that this question came back right before the end of the year. So, some of us, we’re still using ICD-9. I know most of you are going, gasp. We did transition to ICD-10 on October 1st but ICD-9 is still around and in use, especially for some of those Medicare Advantage Plans that don’t have all their data in from before October 1st. So, that’s really where this question came from.

When we look at the ICD-9 manual, we use to see all of these morphology codes in the Index. If you don’t know what I mean by a morphology code, in ICD-9 if you were looking in the index and let’s say you went to the word ‘carcinoma,” chances are after the word (carcinoma) you would see this – it was M and then four numbers with a slash and another number. So, it would be like M5090/1. It would be something to that effect.

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Those numbers didn’t really mean anything if you didn’t understand what they were. They were morphology codes and there was this Appendix in the back of ICD-9 that explained what those morphology codes were.

Those morphology codes were basically there to tell you what kind of tumor you were dealing with, whether you were dealing with a malignancy or a benign tumor or a carcinoma in situ, all of those things. So, your question is, “Well, do these come into play?” Well, just as Alicia has highlighted for me there. This is all about cancer and tumor registries.

If you work for a cancer registry or a tumor registry, these are things you’re familiar with and you’re like, “Why are we talking about morphology codes again? I already know this.” But unless you work in one of those areas you probably saw them and like, “Why are they here? Why hasn’t anybody explain them to me? Nobody tells me what all these things mean.” That’s because outside of the cancer and tumor registry they’re not used, and now that we’ve gone to ICD-10 you’re going to find that there’s no more morphology codes in the index of the book. If you see an M code in the index for ICD-10 that is a musculoskeletal code that has nothing to do with the type of cancer or tumor that you’re dealing with.

There’s also no longer an appendix in the back of ICD-10 that talks about morphology. The reason for that being in the index of ICD-10 they’ve already built the morphology codes into the way you look them up. So an ICD-9, where you looked up carcinoma and it told you, “Oh you need to look up this M code to figure out what kind it is.” Now on ICD-10, when you look up carcinoma it’s going to ask you, “Where is this?” and it’s going to tell you that if it’s a carcinoma those are almost always malignant, so it’s going to walk you through, and send you to the right cells, or the right codes, and you may have options for, “OK, yeah, it’s a carcinoma of this particular area.”

Is it squamous cell? Is it Merkel cell? Is it basal cell? What kind of carcinoma is it? So they get more in-depth than they did on ICD-9, so we saw those morphology codes go away, but those morphology codes were there to identify the type of tumor for cancer registries, and those are all used for statistical reporting, so that we can try to figure out what the triggers are for some of those tumors, and as they begin to identify what they are, or exposure to certain things they can link it back, so that we can try to prevent cancer, and develop treatment for cancers going forward.

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Morphology Codes - What Are They Used For

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