C77.5
BillableSecondary and unspecified malignant neoplasm of intrapelvic 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 located inside the pelvis, either as a secondary spread from another cancer or when the primary source is unknown.
Coding Tips
- •This code applies to metastatic disease to intrapelvic lymph nodes; always identify and code the primary cancer site when known
- •Intrapelvic lymph nodes include iliac, obturator, and sacral lymph nodes
Clinical Significance
Secondary and unspecified malignant neoplasm of intrapelvic lymph nodes represents metastatic disease to the iliac, obturator, or other internal pelvic lymph node chains. This commonly occurs with gynecologic cancers (cervical, uterine, ovarian), prostate cancer, bladder cancer, and rectal cancer. Pelvic nodal metastasis often upstages the disease and changes treatment planning.
Documentation Requirements
- ✓Imaging (CT pelvis, PET, MRI) confirming malignant intrapelvic lymphadenopathy
- ✓Pathology when available from lymph node biopsy or surgical specimen
- ✓Identification and separate coding of the primary malignancy
- ✓Specific lymph node chains involved (iliac, obturator, presacral)
- ✓Staging implications and treatment plan modifications
Commonly Confused Codes
C77.2 — Intra-abdominal lymph nodes: Abdominal nodes above the pelvic brim, not intrapelvicC77.4 — Inguinal and lower limb lymph nodes: External/superficial nodes, not deep pelvic nodesC76.3 — Malignant neoplasm of pelvis (ill-defined): Primary pelvic tumor, not nodal metastasisC81-C86 — Lymphomas: Primary lymph node malignancy, not metastaticN59 — Other disorders of pelvic organs: Non-malignant pelvic conditions
Code Hierarchy
└C77Secondary and unspecified malignant neoplasm of lymph nodes└C77.5Secondary and unspecified malignant neoplasm of intrapelvic lymph nodes
└C77.5Secondary and unspecified malignant neoplasm of intrapelvic lymph nodes