Wiki GIST-gastrointestinal tumor DX on path/44120

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G
Code: C49.A

Code Name: ICD-10 Code for Gastrointestinal stromal tumor

Block: Malignant neoplasms of mesothelial and soft tissue (C45-C49)

Details: Gastrointestinal stromal tumor
C49

Includes: malignant neoplasm of blood vessel
malignant neoplasm of bursa
malignant neoplasm of cartilage
malignant neoplasm of fascia
malignant neoplasm of fat
malignant neoplasm of ligament, except uterine
malignant neoplasm of lymphatic vessel
malignant neoplasm of muscle
malignant neoplasm of synovia
malignant neoplasm of tendon (sheath)

Excludes1: malignant neoplasm of cartilage (of):articular (C40-C41)
larynx (C32.3)
nose (C30.0)
malignant neoplasm of connective tissue of breast (C50.-)

Excludes2: Kaposi's sarcoma of soft tissue (C46.1)
malignant neoplasm of heart (C38.0)
malignant neoplasm of peripheral nerves and autonomic nervous system (C47.-)
malignant neoplasm of peritoneum (C48.2)
malignant neoplasm of retroperitoneum (C48.0)
malignant neoplasm of uterine ligament (C57.3)
mesothelioma (C45.-)

Guidelines: Neoplasms (C00-D49)

Note: Functional activity
All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
Morphology [Histology]
Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
Primary malignant neoplasms overlapping site boundaries
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
Malignant neoplasm of ectopic tissue
Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).

For more details on C49.A, ICD-10 Code for Gastrointestinal stromal tumor , visit: https://coder.aapc.com/icd-10-codes/

Trendale

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Hello,

Do anyone know the correct way to code GIST-Gastrointestinal Tumor? The op report says Duodenal neoplasm, so I went to the pathe report and it stated GIST. It does not specify Benign or malignant. In the ICD-9 under tumor-stromal-gastrointestinal, it has 3 specifications:benign 215.5, malignant 171.5 and unc beh 238.1, next to GI, has 238.1. I am thinking to code 238.1 because the path report does not state benign or malignant.

Also, my next question, in my coding billing book, 238.1 is not listed as a covered DX. What should I do?

Thanks!:)
 

mitchellde

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Tumors are coded as neoplsm unspecified. It indicates a working dx until further studied is performed to determine the morphology of the cells.
 

Trendale

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reply

The op report stated duodenal neoplasm, whcih in that case if that was the only dx given at that time, then I would go to the neoplasm chart and code neoplasm unspecified. However, the path is in ,which states GIST, the way I understood coding tumors, was to go to tumor first before going to the neoplasm chart and follow what it tells you to do. There is a dx for GIST under tumor, it does not send me to the neoplasm chart. Please look under tumor, stromal, gastrointestinal and tell me in what case you would use this DX. After I went there, that is where I was unsure of the choices it gives you (benign .malignant or 238.1), which made me post a question, being that the path did not state benign or malignant, the only choice that was left under the subcategory GIST was 238.1.
 

rmwinder

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A GIST tumor is a sarcoma and as such is definitely malignant.
But, since this thread is so old, I'm sure that doesn't help you anymore! Hopefully, anyone seeing it in the future will benefit.
 

gared111

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I respectfully disagree with the last two posts. The correct dx for a GIST Tumor is 238.1. The info provided doesn't specify benign or malignant, and they are not always malignant as stated by rmwinder.

Here is a quote from www.cancer.gov " Gastrointestinal stromal tumors (GISTs) may be malignant (cancer) or benign (not cancer). They are most common in the stomach and small intestine but may be found anywhere in or near the GI tract...."

Look up code 238.1 in the back of your ICD9 book. Under the code description it specifically states "Stromal tumors of digestive system".
 
Last edited:

cynthiabrown

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I asked my doctor about this and she said anything over 5 cm and 50 HPF or more is considered malignant
 

gared111

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I asked my doctor about this and she said anything over 5 cm and 50 HPF or more is considered malignant
I have never heard that, but if that's the case, the path report would state it's malignant. The original poster stated the path report did not indicate benign or malignant.
 

kguzie

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GIST diagnosis

According to ICD-9, a malignant neoplasm of connective and other soft tissue of internal organs is coded to malignant neoplasm of the site: i.e. 151.9 for malignant GIST of stomach.
 
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