C77.4
BillableSecondary and unspecified malignant neoplasm of inguinal and lower limb lymph nodes
HCC Category Mapping
V28HCC 18 — Metastatic Cancer to Peritoneum and Other Specified Sites
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 the lymph nodes in the groin and lower leg area, either as a secondary spread from another cancer or when the primary source is unknown.
Coding Tips
- •Code the primary malignancy separately when identified; this code specifically indicates lymph node involvement in the inguinal and lower limb regions
- •Do not use this code for primary lymphomas originating in these nodes; use appropriate lymphoma codes instead
Clinical Significance
Secondary and unspecified malignant neoplasm of inguinal and lower limb lymph nodes represents metastatic cancer involving the groin or lower extremity lymph nodes. This commonly occurs with melanoma of the lower extremity, vulvar cancer, penile cancer, and anal cancer. Inguinal lymph node dissection is a common staging procedure for several of these malignancies.
Documentation Requirements
- ✓Pathology confirming malignant involvement of inguinal or lower limb lymph nodes
- ✓Identification and separate coding of the primary malignancy
- ✓Number of involved nodes and extent of disease
- ✓Laterality of inguinal nodal involvement
- ✓Treatment plan including any planned lymph node dissection
Commonly Confused Codes
C77.3 — Axillary and upper limb lymph nodes: Upper extremity, not lowerC77.5 — Intrapelvic lymph nodes: Internal pelvic nodes vs. inguinal/lower limb nodesC63.2 — Malignant neoplasm of scrotum: Primary scrotal malignancy, not inguinal nodesC81-C86 — Lymphomas: Primary lymph node malignancyL04.3 — Acute lymphadenitis of lower limb: Infectious/inflammatory, not malignant