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Standard Treatment & Surgery Codes

Standard Treatment

Generally the treatment of choice is surgery unless the tumor is in an inaccessible or delicate area, such as in speech, vision, or motor control area. Some tumors are so aggressive that they also need radiation therapy.

S = Surgery
R = Radiation therapy
C = Chemotherapy
( ) = Optional treatments

Tumor Treatment
Astrocytoma, noninfil. S(+R)
Astrocytoma, anaplastic S+R
Astrocytoma, high grade S+R(+C)
Glioblastoma multiforme S+R+C
Brain stem glioma R
Ependymoma, w-d S(+R)
Ependymoma, anaplastic S+R
Oligodendroglioma S(+R)
Oligodendroglioma, anaplastic S+R(+C)
Mixed glioma S+R(+C)
Medulloblastoma S(+R)
Pineal parenchymal tumor S+R(+C)
CNS germ cell tumor S(+R)
Craniopharyngioma S(+R)
Meningioma, w-d S(+R)
Meningioma, malignant S+R

Surgery Codes

CNS sites included in brain related sites fall under 2 separate surgery schemes. BRAIN and ALL Others. The Brain codes include the brain and spinal cord as well as the meninges. The Other Sites include the pitutitary and pineal glands & the craniopharyngeal duct.

The following Surgical Procedure of Primary Site codes are used when the primary site is meninges, brain, spinal cord, cranial nerves, or other parts of the CNS. (C70-0-C70.9, C71.0-C71.9, C72.0-C72.9)

  • 10 — Tumor destruction NOS
  • 20 — Local Tumor Excision, NOS
  • 40 — Partial resection
  • 55 — Gross total resection
  • 90 — Surgery, NOS

The following Surgical Procedure of Primary Site codes are used when the site is pituitary gland (C75.1), craniopharyngeal duct (C75.2), or pineal gland (C75.3). They are the surgery codes used for all other sites.

  • 10 — Local tumor destruction, NOS
  • 20 — Local tumor excision, NOS
  • 40 — total surgical removal of the primary site
  • 50 — Surgery stated to be "debulking"
  • 60 — Radical surgery
  • 90 — Surgery, NOS

Other surgical data fields are completed for CNS tumors as they are for other malignant primaries. Directions for coding the surgical data fields can be found in FORDS manual.