Neuroendocrine tumor

annettebec

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What ICD10 would you assign to: Pancreatic neck mass, Low-grade neuroendocrine tumor. Here are the guidelines I have been given: Any help appreciated.
Neuroendocrine tumors are almost always malignant
* If graded they are malignant
* If malignant look under tumor carcinoid
* If the cancer has not spread to lymph nodes or other parts of the body then see neuroendocrine, other specified
* C7A8 is for other malignant endocrine tumors, not classified as carcinoid
 
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Hi Annette,
For all of the reasons you've stated above, I also would code C7A.8.
Neuroendocrine tumors are a constant evolution in our coding department, too. I often have to query the pathologist further.
From conversations with one of our pathologists, "Carcinoid" is an outdated term and it seems like this may be an area where ICD-10 nomenclature has yet to catch up.
Hope this is helpful,
Laurie
UPDATE:
I've edited my response because it is true that without seeing the entire report, I should not have advised (it's bad form). BUT... I do think that you're on the right track, and I especially appreciate the response that followed mine (Dana Chock) And thank you annettebec, for asking the question about neuroendocrine tumors. These are some of my questions, too.
 
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danachock

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Hi annettebec,
I so do apologize for not replying earlier. But in my wholehearted opinion the Neuroendocrine Tumors are NOT CLEARLY DEFINED in our ICD book and haven't been for a long while. I am sure my pathologists are simply tired of my repeated requests for clarification and that my colleagues are also probably querying the heck out of their pathologists on these coding scenarios too.
Something needs to be done; and to frankly (again in my opinion) clear the "mud" on these coding scenarios. Our ICD book in a sense seems like a dinosaur and is "outdated" for our current coding scenarios. Even medical necessity is out the door checking the guidelines using the majority of these diagnosis codes.
I referred to a few resources when reviewing to your specific coding scenario. I am not in a position to provide accurate diagnosis coding assignment suggestion because I don't have enough quality evidence to again "clear the mud" and give you the proper code selection or advice that you need for proper diagnosis code assignment, but I wanted to leave you with a few things I found alright. I will need to leave this to your interpretation of the pathology report to render the correct diagnosis on this one. I used multiple sites I have personally book marked, but in my opinion the cancer.org and SEER website are my favorite go to websites.
What Is a Pancreatic Neuroendocrine Tumor?
SEER Inquiry System - Search
Please let me know if my copy and paste links did not work correctly. You may want to bookmark them and use them moving forward in your pathology coding career if you find them helpful? I really did attempt to Snip and paste them into our discussion, but both websites were unhappy with that idea.
If anyone disagrees with my "opinion(s)", I would like you to share your otherwise reasoning or disagreements please. I seriously have been hoping that the WHO would figure this out for a while now. This is long overdue "again in my complete opinion".
Have a fantastic evening please!
Thank you for listening,
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT
 
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