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GIST-gastrointestinal tumor DX on path/44120

  1. Default GIST-gastrointestinal tumor DX on path/44120
    Medical Coding Books

    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?


  2. #2
    Columbia, MO
    Tumors are coded as neoplsm unspecified. It indicates a working dx until further studied is performed to determine the morphology of the cells.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default 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.

  4. #4
    Columbia, MO
    Do you have the entire path report? if so does it say anything else?

    Debra A. Mitchell, MSPH, CPC-H

  5. Default Reply
    Yes, the entire path, and the final path DX states GIST.

  6. #6
    Gulf Coast - GCAPC
    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.
    Rhonda Winder, CPC

  7. Default

  8. #8
    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 by gared111; 05-16-2014 at 01:13 PM.

  9. #9
    I asked my doctor about this and she said anything over 5 cm and 50 HPF or more is considered malignant

  10. #10
    Quote Originally Posted by cynthiabrown View Post
    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.

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