C78.2
BillableSecondary malignant neoplasm of pleura
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 18 — Metastatic Cancer to Lung and Other Respiratory Sites
0.000What This Code Means
Cancer that has spread to the pleura, which is the thin membrane that lines the lungs and chest wall.
Coding Tips
- •Pleural involvement is distinct from lung parenchymal involvement; do not use C78.0x codes for pleural disease
- •Document whether pleural involvement is unilateral or bilateral; code the primary cancer site separately
Clinical Significance
Secondary malignant neoplasm of the pleura indicates metastatic cancer involving the membrane lining the lungs and chest cavity. Pleural metastases frequently cause malignant pleural effusions, which significantly impair respiratory function and quality of life. This is distinct from lung parenchymal metastases and often requires specialized management including thoracentesis or pleurodesis.
Documentation Requirements
- ✓Primary cancer site documented and coded separately
- ✓Imaging confirmation (CT, ultrasound) or cytological confirmation from pleural fluid analysis
- ✓Whether a malignant pleural effusion is present — if so, code additionally with J91.0
- ✓Laterality of pleural involvement (right, left, bilateral) if documented
- ✓Treatment approach — thoracentesis, pleurodesis, indwelling pleural catheter
Commonly Confused Codes
C78.00-C78.02 — Secondary malignant neoplasm of lung; pleural involvement is distinct from lung parenchymal metastasesC45.0 — Mesothelioma of pleura; mesothelioma is a primary pleural malignancy, not metastaticJ91.0 — Malignant pleural effusion; this is the effusion itself, not the underlying pleural metastasis — code bothC38.4 — Primary malignant neoplasm of pleura; verify secondary versus primary origin
Code Hierarchy
└C78Secondary malignant neoplasm of respiratory and digestive organs└C78.2Secondary malignant neoplasm of pleura
└C78.2Secondary malignant neoplasm of pleura