Wiki Neuroendocrine of the Pancreas?

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emonet01

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Good afternoon, I am wondering if I could get some advice on proper coding for a Neuroendocrine Carcinoma of the Pancreas. Our team of 6 coders is divided as to whether you code to the site C25._ or Code the Neuroendocrine of the Foregut C7A.094. Does anyone have any good literature they could suggest about coding Neuroendocrine tumors?

Let me know what you think. :) thanks for your help.
 
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Ok so for a diagnosis stated specifically as neuroendocrine carcinoma of pancreas will definitely fall under the C7A- category. Best way to explain this is just by your ICD-10-CM index, if you go to Carcinoma>Neuroendocrine, it guides you to this specific section of codes.

Now, C7A.094 of the foregut also is a good option for the specific diagnosis above since the foregut does include the pancreas.

There are 3 distinct sections; foregut, midgut and hindgut. Foregut gives rise to the esophagus, stomach, liver, gallbladder, bile ducts, pancreas and proximal duodenum. The midgut develops into the distal duodenum, jejunum, ileum, cecum, appendix, ascending colon, and proximal 2/3 of transverse colon. The hindgut becomes the distal 1/3 of the transverse colon, descending colon, sigmoid colon and the upper anal canal.

Also, here is an interesting article in regards the physiology of NETs (Neuroendocrine tumors)


hope this helps!
 
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So - Neuroendocrine carcinoma and carcinoid's are not exactly the same things. We usually code the neuroendocrine carcinoma of pancreas to C7A.8 (or possibly C7A.1 depending on path). I would only code it to the C7A.094 if the pathology said "carcinoid".

"Both ​
carcinoid​
tumor (​
carcinoid​
) and neuroendocrine ​
carcinoma​
(NEC) are composed of neuroendocrine cells which are positive for chromogranin. The former is a low grade malignancy but NEC is a highly aggressive malignancy"​
 
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The coding depends on the grade of the tumor. Low Grade Neuroendocrine is the new term for Carcinoid so that would be C7A.094 in this case. If it is High Grade or Poorly Differentiated it would be the C7A.1. It would depend on the the pathology report.
 
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Munzueta said:
Ok so for a diagnosis stated specifically as neuroendocrine carcinoma of pancreas will definitely fall under the C7A- category. Best way to explain this is just by your ICD-10-CM index, if you go to Carcinoma>Neuroendocrine, it guides you to this specific section of codes.

Now, C7A.094 of the foregut also is a good option for the specific diagnosis above since the foregut does include the pancreas.

There are 3 distinct sections; foregut, midgut and hindgut. Foregut gives rise to the esophagus, stomach, liver, gallbladder, bile ducts, pancreas and proximal duodenum. The midgut develops into the distal duodenum, jejunum, ileum, cecum, appendix, ascending colon, and proximal 2/3 of transverse colon. The hindgut becomes the distal 1/3 of the transverse colon, descending colon, sigmoid colon and the upper anal canal.

Also, here is an interesting article in regards the physiology of NETs (Neuroendocrine tumors)


hope this helps!
Click to expand...
Thanks for that link - it's an awesome site with lots of good, useful info!
 
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If the pathology states, neuroendocrine tumor (high differentiated/poorly differentiated) the specific ICD for NE is C7A.1. (Any site). Code the histology if known. A carcinoid NE is a subset of NE cancers. I agree with 'dkb6126" , I assign carcinoid if the pathology specifically states 'carcinoid' cancer. There is specific staining to determine that. By coding neuroendocrine of pancreas by site, then the histology is not specified, and these cancers are more aggressive. BTW, neuroendocrine cancers can be small cell and large cell, but most are small cell. If the Dr. indicates only, small cell cancer, I code by site.
 
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