C77.1
BillableSecondary and unspecified malignant neoplasm of intrathoracic lymph nodes
HCC Category Mapping
V28HCC 17 — Metastatic Cancer and Acute Leukemia
0.368V24HCC 8 — Metastatic Cancer and Acute Leukemia
2.484ESRDHCC 8 — Metastatic Cancer and Acute Leukemia
0.000RxHCCHCC 20 — Cancer, Liver and Intrahepatic Bile Duct
0.000What This Code Means
Cancer that has spread to or originated in the lymph nodes inside the chest cavity.
Coding Tips
- •This code applies to malignancies affecting intrathoracic (mediastinal and hilar) lymph nodes
- •Document whether this represents secondary spread from another primary cancer or a primary lymph node malignancy
Clinical Significance
Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes represents metastatic disease to mediastinal, hilar, or other thoracic lymph nodes. This is commonly seen with lung cancer, breast cancer, esophageal cancer, and lymphomas presenting with thoracic involvement. Accurate coding of intrathoracic nodal metastases significantly impacts risk adjustment and treatment planning.
Documentation Requirements
- ✓Imaging (CT chest, PET scan) confirming malignant lymphadenopathy in intrathoracic nodes
- ✓Pathology confirmation when available (mediastinoscopy, EBUS biopsy)
- ✓Identification and separate coding of the primary malignancy
- ✓Specific lymph node stations involved (mediastinal, hilar, paratracheal, subcarinal)
- ✓Treatment plan addressing metastatic nodal disease
Commonly Confused Codes
C77.0 — Head, face, neck lymph nodes: Different regional lymph node groupC77.8 — Multiple regional lymph nodes: Use when multiple regions are involvedC38.1-C38.3 — Malignant neoplasm of mediastinum: Primary mediastinal tumor, not metastatic lymph nodesC81-C86 — Lymphomas: Primary lymph node malignancy, not secondary metastatic diseaseR59.0 — Localized enlarged lymph nodes: Non-malignant lymphadenopathy