Coding, Classification and Reimbursement

CIN 2-3

  • 1.  CIN 2-3

    Posted 01-31-2019 06:19

    There has been some discussion in our facility regarding how CIN 2-3 is coding that is documented on path that is sent over to our hospital from a physician's office. Is there a reference/coding clinic that states you should code to the higher or lower on a specimen?

     

    Jenny Hornish, Coder Specialist

    HIMS

     

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  • 2.  RE: CIN 2-3

    Posted 02-01-2019 17:16
    I think you should submit your question to Coding Clinic Advisor.  Cervical intraepithelial neoplasia (CIN) grade 2/3 has features of both grade 2 and grade 3 according to cancer.gov.

    CIN 2 is significantly different from CIN 3.  It is not as though these conditions are classified to two different codes within the same category.  CIN 2 is classified to a code found in ICD-10-CM Chapter 14 Diseases of the Genitourinary System, and CIN 3 is classified to a code found in ICD-10-CM Chapter 2 Neoplasms.  In a diagnosis of CIN grade 2/3, the physician has determined that the specimen has features of both grade 2 and 3.  I don't think that having features of CIN 2 and CIN 3 translates to mean that the patient has a diagnosis of both CIN 2 and CIN 3.

    Looking directly to the index for guidance, go to Neoplasia as the main term and intraepithelial and cervix as subterms.  Under Neoplasia, intraepithelial, cervix, there is no subterm for "grade 2/3" or "grade II/III."  The code that I arrive at according to the index and tabular is N87.9.  Even so, I think that this question should be addressed with authoritative coding advice since CIN grade 2/3 is not an unspecified grade.

    Home Page - American Hospital Association

    https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cervical-intraepithelial-neoplasia-grade-2-3



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    Judy Bielby
    Consultant and educator
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