AAPC - Back to school
Results 1 to 3 of 3

Thread: Small Cell vs Neuroendocrine

  1. #1

    Question Small Cell vs Neuroendocrine

    AAPC: Back to School
    We have a patient sent to us from a cancer center in a different state. The doctor diagnosed it as small cell carcinoma of the esophagus, mets to the brain. Histology is small cell neuroendocrine. The pathology states small cell neuroendocrine carcinoma. It was coded 209.79 & 209.30, and is being denied because these codes are not covered for Radiation as per our local Medicare LCD. Should it be coded for metastatic esophageal or 198.3 (brain mets) from V10.03 (hx of esophagus).
    Any and all comments will be appreciated.

  2. #2


    what area are you treating w/ XRT?

    is it brain mets w/ hx of esophogeal ca or is the esophagus ca currently being treated?

    Are there two path reports one reporting small cell carcinoma and one reporting small cell neuroendocrine?

  3. #3
    Join Date
    Apr 2007


    I could be wrong on this, but I believe we are instructed by ICD-9 to code the location of the malignancy (esophagus), not the histology (neuroendocrine). So for malignant neoplasm of esophagus, primary I would use 150.x, and secondary malignant neoplasm of bone 198.5. If the radiation therapy is being directed at the bone neoplasm then 198.5 should be the first listed diagnosis used in conjunction with the XRT for billing.

Similar Threads

  1. Neuroendocrine vs small cell lung
    By kjenisch in forum Hematology/Oncology
    Replies: 0
    Last Post: 01-19-2015, 02:19 PM
  2. need help coding small cell neuroendocrine tumor of pancreas
    By rlazcano@ucsd.edu in forum Diagnosis Coding
    Replies: 2
    Last Post: 04-19-2014, 09:25 AM
  3. Replies: 2
    Last Post: 10-01-2013, 09:52 AM
  4. Neuroendocrine w/small cell features
    By KMayercsik in forum Hematology/Oncology
    Replies: 2
    Last Post: 10-13-2011, 01:18 PM
  5. Neuroendocrine vs Small Cell
    By KMayercsik in forum Pathology & Clinical Laboratory
    Replies: 0
    Last Post: 12-09-2010, 10:47 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.