Lupita1983
Contributor
Hello everyone, I have a question regarding Neuroendocrine Tumors PLEASE!
When I see neuroendocrine tumor, I go to the words before "neuroendocrine" and/or after "neuroendocrine" which depending on who my pathologist is will say something like:
Poorly differentiated, Neuroendocrine Tumor = which will automatically take me to code C7A.1
Malignant poorly differentiated neuroendocrine carcinoma = C7A.1
Neuroendocrine tumor, WHO grade III = C7A.1
Those are given to me, but what about the following:
Neuroendocrine tumor, well differentiated = I believe it should be D3A.8
Neuroendocrine tumor, WHO grade I = I believe it should be D3A.8
I have asked for clarification from my pathologists who say Neuroendocrine should automatically be coded as MALIGNANT and I don't agree because if that were the case, then why would our book have a D code for them? I believe that WHO classifications of I and II should be D3A.8 and WHO grade III should be C7A.1
But of course, it's not that easy. I have the following case:
Left kidney: Neuroendocrine tumor, well differentiated, WHO grade I, see comment.
I automatically think its my D code, but then when I go to comment is says:
Comment: IHC findings favor primary site as GI or pancreas
Now I know we don't utilize FAVOR for diagnosing, but it makes me think that this is a malignant tumor because how does a benign tumor metastasize to a different organ? Doesn't make sense. I have never heard of it but again, I am sure there are things I don't know. Any help would be appreciated. Thank you for your time.
When I see neuroendocrine tumor, I go to the words before "neuroendocrine" and/or after "neuroendocrine" which depending on who my pathologist is will say something like:
Poorly differentiated, Neuroendocrine Tumor = which will automatically take me to code C7A.1
Malignant poorly differentiated neuroendocrine carcinoma = C7A.1
Neuroendocrine tumor, WHO grade III = C7A.1
Those are given to me, but what about the following:
Neuroendocrine tumor, well differentiated = I believe it should be D3A.8
Neuroendocrine tumor, WHO grade I = I believe it should be D3A.8
I have asked for clarification from my pathologists who say Neuroendocrine should automatically be coded as MALIGNANT and I don't agree because if that were the case, then why would our book have a D code for them? I believe that WHO classifications of I and II should be D3A.8 and WHO grade III should be C7A.1
But of course, it's not that easy. I have the following case:
Left kidney: Neuroendocrine tumor, well differentiated, WHO grade I, see comment.
I automatically think its my D code, but then when I go to comment is says:
Comment: IHC findings favor primary site as GI or pancreas
Now I know we don't utilize FAVOR for diagnosing, but it makes me think that this is a malignant tumor because how does a benign tumor metastasize to a different organ? Doesn't make sense. I have never heard of it but again, I am sure there are things I don't know. Any help would be appreciated. Thank you for your time.