Biliary tract, primary malignancy: Difference between revisions
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{{ICD10 category|Gastrointestinal}}{{ICD10 category|Neoplastic}}{{ICD10 category|Gastrointestinal neoplasm}} | {{ICD10 category|Gastrointestinal}}{{ICD10 category|Neoplastic}}{{ICD10 category|Primary malignancy}}{{ICD10 category|Gastrointestinal neoplasm}} | ||
== Additional Info == | == Additional Info == | ||
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Includes: | Includes: | ||
* common bile duct | * common bile duct | ||
* ampulla of Vater | * ampulla of Vater - includes ampullary cancer: Ampullary cancer, or ampullary carcinoma, is a cancer that forms in a body part called the ampulla of Vater. The ampulla of Vater is a small opening that enters into the first portion of the small intestine, known as the duodenum. The ampulla of Vater is the spot where the pancreatic and bile ducts release their secretions into the intestines | ||
{{ICD10 Guideline Cancer}} | |||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||
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== Related CCI Codes == | == Related CCI Codes == | ||
{{Data Integrity Check List}} | |||
== Related Articles == | == Related Articles == | ||
{{Related Articles}} | {{Related Articles}} | ||
{{ICD10 footer}} | {{ICD10 footer}} | ||
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Latest revision as of 14:15, 6 July 2022
| ICD10 Diagnosis | |
| Dx: | Biliary tract, primary malignancy |
| ICD10 code: | C24 |
| Pre-ICD10 counterpart: | Biliary Tree Cancer |
| Charlson/ALERT Scale: | Any malignancy, including lymphoma and leukemia, except of skin |
| APACHE Como Component: | none |
| APACHE Acute Component: | 2019-0: GI surgery for neoplasm |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
Excludes:
- intrahepatic bile ducts - code as Liver, primary malignancy
- Gallbladder, primary malignancy
- Liver, primary malignancy
Includes:
- common bile duct
- ampulla of Vater - includes ampullary cancer: Ampullary cancer, or ampullary carcinoma, is a cancer that forms in a body part called the ampulla of Vater. The ampulla of Vater is a small opening that enters into the first portion of the small intestine, known as the duodenum. The ampulla of Vater is the spot where the pancreatic and bile ducts release their secretions into the intestines
Using ICD10 Malignancy Codes as a Comorbid Diagnosis
- Any cancer/malignancy (either a "solid tumor" or a leukemia/lymphoma/bone marrow malignancy/"liquid tumor", i.e. any ICD10 code from C00-C99) can be a comorbid diagnosis --- BUT it's vital to distinguish malignancies in this category based on whether they are believed to be cured or not.
- If it's still present (or believed to be present), then just include the code for the specific cancer as a comorbid diagnosis.
- If INSTEAD, it's presumed cured, then in the "bin" of comorbid diagnoses combine the code for the specific cancer with this code: Past history, cancer (any type), believed cured
Metastases
| Metastasis codes: |
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Regarding Presumptive Diagnosis of Malignancy
- Rarely a presumptive diagnosis is made without any tissue confirmation. This generally occurs with:
- risk of obtaining tissue is very high
- plan would be palliative regardless
- patient would refuse care regardless.
- Our issue for how to code a presumed malignancy without definitive histopathologic proof is this:
- If the physicians are going to proceed with a treatment plan without that definitive histopathologic proof --- then code whatever is their best guess about what is present. Example: believed to be lung cancer with a big brain met, and they've decided NOT to do any biopsy but to give palliative radiation therapy, then you'd code lung cancer, and met to brain.
- If the plan is to obtain a definitive histopathologic diagnosis soon or in the future, then instead code: Neoplasm of uncertain behavior (i.e. not clear if benign or malignant), NOS
"work-up for cancer"
If the cancer has not been confirmed then it should not be coded as cancer. Code relevant test abnormal test results or symptoms.
| Testing codes: |
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| Symptom/Sign codes: |
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| Example: |
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"I have a patient who comes in with vague respiratory and gi symptoms. They did a chest xray and found a lung mass. They are now working him up for a probable lung ca, with mets to various places. In the old coding I would use ca-nyd. I actually use the ca nyd subcode a lot. I’ve talked to you about this before, because there is no ca nyd in icd10. You told me that you either have cancer or you don’t. For this particular patient I really wouldn’t have anything else I could code in icd10 for him. His symptoms are extremely vague. I don’t really like coding just symptoms, if there isn’t a proper admit diagnosis that fits better anyway. I found a “neoplasm of uncertain behavior (i.e. uncertain if benign or malignant), nos”, but I don’t really like that one. It doesn’t really fit. Is it possible to get something like “admit for workup of malignancy”, or something along those lines?" (Debbie, 12:40, 2018 October 4 (CDT)) How should this be coded? Ttenbergen 12:40, 2018 October 4 (CDT) |
Alternate ICD10s to consider coding instead or in addition
| Gastrointestinal neoplasm codes: |
|
- Liver or biliary system, benign neoplasm
- Liver or biliary system, metastatic malignancy to it (also code primary site)
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)
none found
Related Articles
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