C38.2
BillableMalignant neoplasm of posterior mediastinum
HCC Category Mapping
V28HCC 21 — Breast, Prostate, Colorectal and Other Cancers and Tumors
0.545V24HCC 11 — Colorectal, Bladder, and Other Cancers
0.306ESRDHCC 11 — Colorectal, Bladder, and Other Cancers
0.000RxHCCHCC 22 — Cancer, Other Specified Sites
0.000What This Code Means
Cancer located in the posterior mediastinum, which is the space behind the heart and between the lungs in the chest.
Coding Tips
- •Posterior mediastinum is the back portion of the central chest cavity; document specific location if known
- •Use C38.3 if the mediastinal location is not further specified
Clinical Significance
Posterior mediastinal cancers are less common than anterior mediastinal tumors and typically include neurogenic tumors (schwannomas, neurofibromas, ganglioneuromas) and esophageal cancers extending posteriorly. The posterior mediastinum contains the esophagus, descending aorta, thoracic vertebrae, and sympathetic chain, making surgical access challenging.
Documentation Requirements
- ✓Pathology confirming malignancy and histological type (neurogenic tumors most common posteriorly)
- ✓Imaging specifying posterior mediastinal location
- ✓Assessment of vertebral, aortic, or esophageal involvement
- ✓Documentation distinguishing from esophageal cancer with mediastinal extension
- ✓Neurological assessment if spinal cord involvement is suspected
Commonly Confused Codes
C38.1 — Anterior mediastinum: Different compartment with different tumor typesC38.3 — Mediastinum, unspecified: Use only when the specific compartment cannot be determinedC15.5 — Lower third of esophagus: Esophageal cancers in the posterior mediastinum should use esophageal codesC47.3 — Malignant neoplasm of peripheral nerves of thorax: Neurogenic tumors may be more specifically coded
Code Hierarchy
└C38Malignant neoplasm of heart, mediastinum and pleura└C38.2Malignant neoplasm of posterior mediastinum
└C38.2Malignant neoplasm of posterior mediastinum