C34.11 is a billable diagnosis code used to specify a medical diagnosis of malignant neoplasm of upper lobe, right bronchus or lung. The code C34.11 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code C34.11 might also be used to specify conditions or terms like adenocarcinoma of right lung, malignant neoplasm of right upper lobe of lung, malignant neoplasm of upper lobe bronchus, neoplasm of bronchus of right upper lobe, primary adenocarcinoma of upper lobe of right lung , primary malignant neoplasm of bronchus of right upper lobe, etc.
The following anatomical sites found in the Table of Neoplasms reference the parent code C34.1 of the current diagnosis code given the correct histological behavior: bronchus upper lobe of lung or lingula, lung or lung azygos lobe or lung linqula or lung upper lobe .
The code C34.11 is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Lung Cancer Reporting (biopsy/cytology Specimens) , Lung Cancer Reporting (resection Specimens).
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Adenocarcinoma of right lung
- Malignant neoplasm of right upper lobe of lung
- Malignant neoplasm of upper lobe bronchus
- Neoplasm of bronchus of right upper lobe
- Primary adenocarcinoma of upper lobe of right lung
- Primary malignant neoplasm of bronchus of right upper lobe
- Primary malignant neoplasm of upper lobe of right lung
- Primary malignant neoplasm of upper lobe of right lung
- Squamous cell carcinoma of bronchus
- Squamous cell carcinoma of bronchus in right upper lobe
- Squamous cell carcinoma of right lung
Diagnostic Related Groups - MS-DRG Mapping
|MS-DRG||MS-DRG Title||MCD||Relative Weight|
|180||RESPIRATORY NEOPLASMS WITH MCC||04||1.7378|
|181||RESPIRATORY NEOPLASMS WITH CC||04||1.1209|
|182||RESPIRATORY NEOPLASMS WITHOUT CC/MCC||04||0.7875|
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert C34.11 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code C34.11 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Quality Payment Program Measures
When code C34.11 is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.
|Quality Measure||Description||Quality Domain||Measure Type||High Priority||Submission Methods|
|Lung Cancer Reporting (Biopsy/Cytology Specimens)||Pathology reports based on biopsy and/or cytology specimens with a diagnosis of primary non-small cell lung cancer classified into specific histologic type or classified as non-small cell lung cancer not otherwise specified (NSCLC-NOS) with an explanation included in the pathology report.||Communication and Care Coordination||Process||YES||Claims, Registry|
|Lung Cancer Reporting (Resection Specimens)||Pathology reports based on resection specimens with a diagnosis of primary lung carcinoma that include the pT category, pN category and for non-small cell lung cancer (NSCLC), histologic type.||Communication and Care Coordination||Process||YES||Claims, Registry|
Table of Neoplasms
The parent code C34.1 of the current diagnosis code is referenced in the table of neoplasms by anatomical site. For each site there are six possible code numbers according to whether the neoplasm in question is malignant, benign, in situ, of uncertain behavior, or of unspecified nature. The description of the neoplasm will often indicate which of the six columns is appropriate.
Where such descriptors are not present, the remainder of the Index should be consulted where guidance is given to the appropriate column for each morphological (histological) variety listed. However, the guidance in the Index can be overridden if one of the descriptors mentioned above is present.
»upper lobe of lung
Information for Patients
What is lung cancer?
Lung cancer is cancer that forms in tissues of the lung, usually in the cells that line the air passages. It is the leading cause of cancer death in both men and women.
There are two main types: small cell lung cancer and non-small cell lung cancer. These two types grow differently and are treated differently. Non-small cell lung cancer is the more common type.
Who is at risk for lung cancer?
Lung cancer can affect anyone, but there are certain factors that raise your risk of getting it:
- Smoking. This is the most important risk factor for lung cancer. Tobacco smoking causes about 9 out of 10 cases of lung cancer in men and about 8 out of 10 cases of lung cancer in women. The earlier in life you start smoking, the longer you smoke, and the more cigarettes you smoke per day, the greater your risk of lung cancer. The risk is also greater if you smoke a lot and drink alcohol every day or take beta carotene supplements. If you have quit smoking, your risk will be lower than if you had kept smoking. But you will still have a higher risk than people who never smoked.
- Secondhand smoke, which is the combination of smoke that comes from a cigarette and smoke breathed out by a smoker. When you inhale it, you are exposed to the same cancer-causing agents as smokers, although in smaller amounts.
- Family history of lung cancer
- Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar in the workplace
- Being exposed to radiation, such as from
- Radiation therapy to the breast or chest
- Radon in the home or workplace
- Certain imaging tests such as CT scans
- HIV infection
- Air pollution
What are the symptoms of lung cancer?
Sometimes lung cancer does not cause any signs or symptoms. It may be found during a chest x-ray done for another condition.
If you do have symptoms, they may include
- Chest pain or discomfort
- A cough that doesn't go away or gets worse over time
- Trouble breathing
- Blood in sputum (mucus coughed up from the lungs)
- Loss of appetite
- Weight loss for no known reason
- Trouble swallowing
- Swelling in the face and/or veins in the neck
How is lung cancer diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms
- A family history
- A physical exam
- Imaging tests, such as a chest x-ray or chest CT scan
- Lab tests, including tests of your blood and sputum
- A biopsy of the lung
If you do have lung cancer, your provider will do other tests to find out how far it has spread through the lungs, lymph nodes, and the rest of the body. This is called staging. Knowing the type and stage of lung cancer you have helps your provider decide what kind of treatment you need.
What are the treatments for lung cancer?
For most patients with lung cancer, current treatments do not cure the cancer.
Your treatment will depend on which type of lung cancer you have, how far it has spread, your overall health, and other factors. You may get more than one type of treatment.
The treatments for small cell lung cancer include
- Radiation therapy
- Laser therapy, which uses a laser beam to kill cancer cells
- Endoscopic stent placement. An endoscope is a thin, tube-like instrument used to look at tissues inside the body. It may be used to put in a device called a stent. The stent helps to open an airway that has been blocked by abnormal tissue.
The treatments for non-small cell lung cancer include
- Radiation therapy
- Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
- Laser therapy
- Photodynamic therapy (PDT), which uses a medicine and a certain type of laser light to kill cancer cells
- Cryosurgery, which uses an instrument to freeze and destroy abnormal tissue
- Electrocautery, a treatment that uses a probe or needle heated by an electric current to destroy abnormal tissue
Can lung cancer be prevented?
Avoiding the risk factors may help to prevent lung cancer:
- Quitting smoking. If you don't smoke, don't start.
- Lower your exposure to hazardous substances at work
- Lower your exposure to radon. Radon tests can show whether your home has high levels of radon. You can buy a test kit yourself or hire a professional to do the test.
NIH: National Cancer Institute
[Learn More in MedlinePlus]
Lung cancer is a disease in which certain cells in the lungs become abnormal and multiply uncontrollably to form a tumor. Lung cancer may not cause signs or symptoms in its early stages. Some people with lung cancer have chest pain, frequent coughing, blood in the mucus, breathing problems, trouble swallowing or speaking, loss of appetite and weight loss, fatigue, or swelling in the face or neck. Additional symptoms can develop if the cancer spreads (metastasizes) into other tissues. Lung cancer occurs most often in adults in their sixties or seventies. Most people who develop lung cancer have a history of long-term tobacco smoking; however, the condition can occur in people who have never smoked.
Lung cancer is generally divided into two types, small cell lung cancer and non-small cell lung cancer, based on the size of the affected cells when viewed under a microscope. Non-small cell lung cancer accounts for 85 percent of lung cancer, while small cell lung cancer accounts for the remaining 15 percent.
Small cell lung cancer grows quickly and in more than half of cases the cancer has spread beyond the lung by the time the condition is diagnosed. Small cell lung cancer often metastasizes, most commonly to the liver, brain, bones, and adrenal glands (small hormone-producing glands located on top of each kidney). After diagnosis, most people with small cell lung cancer survive for about 1 year; less than seven percent survive 5 years.
Non-small cell lung cancer is divided into three main subtypes: adenocarcinoma, squamous cell carcinoma, and large cell lung carcinoma. Adenocarcinoma arises from the cells that line the small air sacs (alveoli) located throughout the lungs. Squamous cell carcinoma arises from squamous cells that line the passages leading from the windpipe (trachea) to the lungs (bronchi). Large cell carcinoma arises from epithelial cells that line the lungs. Large cell carcinoma encompasses non-small cell lung cancers that do not appear to be adenocarcinomas or squamous cell carcinomas. The 5-year survival rate for people with non-small cell lung cancer is usually between 11 and 17 percent; it can be lower or higher depending on the subtype and stage of the cancer.
[Learn More in MedlinePlus]
Non-Small Cell Lung Cancer Summary Learn about non-small cell lung cancer risk factors, symptoms, tests to diagnose, factors affecting prognosis, staging, and treatment.
[Learn More in MedlinePlus]
|ICD Code||Description||Valid for Submission|
|C34||Malignant neoplasm of bronchus and lung||NON-BILLABLE CODE|
|C34.0||Malignant neoplasm of main bronchus||NON-BILLABLE CODE|
|C34.00||Malignant neoplasm of unspecified main bronchus||BILLABLE CODE|
|C34.01||Malignant neoplasm of right main bronchus||BILLABLE CODE|
|C34.02||Malignant neoplasm of left main bronchus||BILLABLE CODE|
|C34.1||Malignant neoplasm of upper lobe, bronchus or lung||NON-BILLABLE CODE|
|C34.10||Malignant neoplasm of upper lobe, unspecified bronchus or lung||BILLABLE CODE|
|C34.12||Malignant neoplasm of upper lobe, left bronchus or lung||BILLABLE CODE|
|C34.2||Malignant neoplasm of middle lobe, bronchus or lung||BILLABLE CODE|
|C34.3||Malignant neoplasm of lower lobe, bronchus or lung||NON-BILLABLE CODE|
|C34.30||Malignant neoplasm of lower lobe, unspecified bronchus or lung||BILLABLE CODE|
|C34.31||Malignant neoplasm of lower lobe, right bronchus or lung||BILLABLE CODE|
|C34.32||Malignant neoplasm of lower lobe, left bronchus or lung||BILLABLE CODE|
|C34.8||Malignant neoplasm of overlapping sites of bronchus and lung||NON-BILLABLE CODE|
|C34.80||Malignant neoplasm of overlapping sites of unspecified bronchus and lung||BILLABLE CODE|
|C34.81||Malignant neoplasm of overlapping sites of right bronchus and lung||BILLABLE CODE|
|C34.82||Malignant neoplasm of overlapping sites of left bronchus and lung||BILLABLE CODE|
|C34.9||Malignant neoplasm of unspecified part of bronchus or lung||NON-BILLABLE CODE|
|C34.90||Malignant neoplasm of unspecified part of unspecified bronchus or lung||BILLABLE CODE|
|C34.91||Malignant neoplasm of unspecified part of right bronchus or lung||BILLABLE CODE|
|C34.92||Malignant neoplasm of unspecified part of left bronchus or lung||BILLABLE CODE|