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Data Element Detail

Episode of care-morphology of neoplasm code (ICD-10-AM 10th edn)
Identifying and Definitional Attributes
QH 041688 v10
Data Element
Data Element
Draft
28-Sep-2017		Current
30-Jan-2018		Superseded
18-Nov-2019
Standard
Information Management Strategic Governance Committee (IMSGC), Queensland Health
01-Jul-2017
30-Jun-2019
The morphology code associated to a neoplasm diagnosis code assigned for an episode of admitted patient care, episode of residential care or attendance at a health care establishment, as represented by a code.
Health services
Morphology (ICD-10-AM)
Morphology code; M code
Representational Attributes
Character
Code
ANNNN/N
7
7
Permissible Values

Permissible_values

A valid 10th edition morphology code from the Corporate Reference Data System (CRDS) ICD-10-AM data set maintained by Statistical Standards and Strategies, Statistical Services Branch (SSB).
Supplementary Values

Supplemenary_values

-
Collection and Usage Attributes
Tumour morphology refers to the type of cell (histology) that has become neoplastic and its biologic activity (behaviour).

ICD-10-AM morphology (M) codes consist of five digits: the first four digits identify the histological type of the neoplasm and the fifth digit, following a slash, indicates its behaviour.

The one digit behaviour code is as follows:

Behaviour Code - Neoplasm category
/0 Benign neoplasms - D10-D36
/1 Neoplasms of uncertain and unknown behaviour - D37-D48
/2 In situ neoplasms - D00-D09
/3 Malignant neoplasms, stated or presumed to be primary - C00-C75, C81-C96
/6 Malignant neoplasms, stated or presumed to be secondary - C76-C80
/9 Malignant, uncertain whether primary or metastatic site

For example a primary neoplasm of the breast (ICD-10-AM code C50.9) should have an associated morphology code ending with a /3 behaviour character.

A morphology code must never be the principal diagnosis.

A morphology code (including the behaviour) must be appropriate to the histological type of the neoplasm.

A morphology code should always be assigned directly after the neoplasm(s) to which it relates. For instances where a /6 metastatic neoplasm morphology and neoplasm is recorded a /3 primary neoplasm site and morphology must be recorded in addition to the metastatic neoplasm and morphology code.

The behaviour of a neoplasm, indicated by the last digit of the morphology code, can change depending on the behaviour description of the neoplasm in the clinical record. For example, a 'superficial spreading non-invasive adenocarcinoma' should be coded to M8143/2 rather than M8143/3 because although the superficial spreading adenocarcinoma is normally classified as 'malignant, primary site' (/3), the description of 'non-invasive' changes the behaviour classification to /2 'carcinoma in situ'.

If a morphological diagnosis contains two histological terms which have different morphology codes, select the highest number as it is usually more specific.
Example: Transitional cell epidermoid carcinoma
Transitional cell carcinoma NOS is coded to M8120/3
Epidermoid carcinoma NOS is coded to M8070/3
In this case, the highest numerical value (M8120/3) should be used.

If the morphology of a neoplasm is unknown and is without any available histology report or clinical clarification, assign M8000/3 Neoplasm, malignant, as advised in Coding Matters Volume 12, Number 3, December 2005.
Must be a valid ICD-10-AM 10th edition code.
ICD-10-AM codes assigned for episodes of admitted patient care are validated against a number of national and state edits (e.g. combination, CPoA, etc) to improve coding quality.
Queensland Hospital Admitted Patient Data Collection (QHAPDC):
Where there are two (or more) different neoplasms with the same morphology code, the appropriate morphology code should be sequenced directly after the last neoplasm site code. However, if one of the neoplasm codes is in the Principal Diagnosis (PD) position, the morphology code should be assigned twice, immediately following the PD, then again following the second neoplasm site code(s) in the Other Diagnosis (OD) position (refer example 3 below).

Example 1: One neoplasm with two histological terms with different morphology codes
Where there is one neoplasm with two histological terms with different morphology codes (e.g. Intraductal papillary adenocarcinoma M8503/3 and medullary carcinoma M8510/3 in a malignant neoplasm of the breast C50.2), code only the morphology code with the highest number.

Principal diagnosis: C50.2 Malignant neoplasm of breast upper inner quadrant of breast
Morphology code: M8510/3 Medullary carcinoma

Example 2: Two separate neoplasms with the same diagnosis code but different morphology codes
The neoplasm diagnosis code should not be repeated when two different sites have the same diagnosis code (e.g. skin of cheek and skin of nose). All the related morphology codes should be reported, with the highest number sequenced first.

Principal diagnosis: C44.3 Malignant neoplasm of skin of other and unspecified parts of face
Morphology code: M8090/3 Basal cell carcinoma NOS
Morphology code: M8070/3 Squamous cell carcinoma NOS

Example 3: Two (or more) neoplasms with different diagnosis codes with the same morphology code
If there are two (or more) site codes with the same morphology and one of the site codes is the principal diagnosis (e.g. adenocarcinoma of the main bronchus, the caecum and the breast), the appropriate morphology codes should be sequenced directly after the principal diagnosis. The second site code (s) should then follow with the morphology, even if it is the same as the morphology related to the principal diagnosis.

Principal diagnosis: C34.0 Malignant neoplasm of main bronchus
Morphology code: M8140/3 Adenocarcinoma NOS
Other diagnosis: C18.0 Malignant neoplasm of caecum
Other diagnosis: C50.9 Malignant neoplasm of breast, unspecified
Morphology code: M8140/3 Adenocarcinoma NOS

Punctuation is excluded in QHAPDC.
Assignment of ICD-10-AM morphology codes is not mandatory for national minimum data set reporting, however, Queensland does collect and report morphology codes for admitted patient episodes of care. The ICD-10-AM morphology codes are derived from the International Statistical Classification of Diseases for Oncology, 3rd Edition (ICD-O-3).
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 10
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementData ElementEpisode of care-morphology of neoplasm code (ICD-10-AM 9th edn)QH 041688 Version 9Superseded
Has been superseded byData ElementData ElementEpisode of care-morphology of neoplasm code (ICD-10-AM 11th edn)QH 041688 Version 11Superseded
Is qualified byData ElementData ElementEpisode of admitted patient care-diagnosis code prefix (ICD-10-AM) (HBCIS)QH 041645 Version 3Superseded
Relates toData ElementData ElementEpisode of care-additional diagnosis code (ICD-10-AM 10th edn)QH 041646 Version 11Superseded
Relates toData ElementData ElementEpisode of care-additional diagnosis code (ICD-10-AM 10th edn)QH 041646 Version 10Superseded
Relates toData ElementData ElementEpisode of care-clinical code (ICD-10-AM/ACHI 10th edn)QH 040100 Version 4Superseded
Relates toData ElementData ElementEpisode of care-principal diagnosis code (ICD-10-AM 10th edn)QH 041644 Version 11Superseded
Relates toData ElementData ElementEpisode of care-principal diagnosis code (ICD-10-AM 10th edn)QH 041644 Version 10Superseded
Relates toData ElementData Element ConceptDiagnosisQH 040789 Version 2Current
Relates toData ElementData Element ConceptEpisode of careQH 041640 Version 1Current
Implementation in Metadata Sets

Implemented

  • 1 - 1
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 1ConditionalSuperseded01-Jul-201730-Jun-2019
Source and Reference Attributes
Independent Hospital Pricing Authority (IHPA)
Australian Coding Standards (ACS), 10th edition, 1 July 2017; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) Tabular List, 10th edition, 1 July 2017, Appendix A Morphology of Neoplasms
CRDI; CRDI QHAPDC; Cancer; Diagnosis; ICD-10-AM codes; Morphology; Neoplasm;