Wiki Why is Small Cell Carcinoma not coded as a neuroendocrine?

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SDBrunner

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Hello!

I code for medical and radiation oncology. In my research I have learned that small cell carcinomas are considered a neuroendocrine cancer, but the ICD-10 book directs us to code as a C34 instead of a C7 (NET) code. Why is that?
 
Small cell carcinomas are a form of a neuroendocrine cancer, but more aggressive and almost always malignant. Carcinoid tumors (the most common kind of neuroendocrine tumor) are also malignant and secrete hormones but aren't anywhere near as aggressive. In fact, up until a few years ago, carcinoids were thought to be benign. We now know that's not true, but you can generally survive a carcinoid cancer if it's caught early enough, but small cell tumors are another story.
 
So my question then is why are we directed by the AAPC to code a small cell lung cancer as a C34.xx neoplasm code and not a C7A.xx neuroendocrine code?

It’s the same for Islet tumors. They are a neoplasm code and not a NET code according to the ICD-10 book.
 
SDBrunner said:
So my question then is why are we directed by the AAPC to code a small cell lung cancer as a C34.xx neoplasm code and not a C7A.xx neuroendocrine code?

It’s the same for Islet tumors. They are a neoplasm code and not a NET code according to the ICD-10 book.
Click to expand...

If you feel it is misclassified, you can take it up with the World Health Organization. The International Classification of Diseases (ICD) version 10 classified small cell carcinoma in C34.

It's not AAPC directing you to C34. That's where the ICD-10 index takes you.
 
Even though the ICD-10-CM Alphabetic Index entry for Carcinoma/small cell directs you to C34.90 (Malignant neoplasm of unspecified part of unspecified bronchus or lung), you should go with a code from C7A.- (Malignant neuroendocrine tumors) for small cell carcinoma with neuroendocrine features. This is consistent with advice found in AHA ICD-10 Coding Clinic Vol. 10, No. 1 (2023).
 
SDBrunner said:
So my question then is why are we directed by the AAPC to code a small cell lung cancer as a C34.xx neoplasm code and not a C7A.xx neuroendocrine code?

It’s the same for Islet tumors. They are a neoplasm code and not a NET code according to the ICD-10 book.
Click to expand...
AAPC doesn't direct ICD-10-CM coding conventions. They support coders, but you need to follow the ICD-10 instructional notes.
 
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