How to Document GI Carcinoid Tumors Using ICD-10 Codes

How to Document

GI Carcinoid Tumors Using ICD-10 Codes

Gastrointestinal carcinoid tumor is a slow-growing tumor that forms in the neuroendocrine cells in the GI tractlining. Knowledge of ICD-10 coding guidelines will help with accurate documentation.

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A Gastrointestinal (GI) carcinoid tumor is a type of cancer that forms in the neuroendocrine cells in the gastrointestinal (GI) tract lining. The GI tract includes the stomach, colon, rectum, small intestine and other organs. GI carcinoid tumors are rare and most grow very slowly. In most cases, these tumors form in the rectum, small intestine, or appendix. Reports suggest that an estimated 12,000 people are diagnosed with a carcinoid tumor each year in the United States (2016 statistics). People who have a family history of multiple endocrine neoplasia type 1 (MEN1) syndrome or neurofibromatosis type 1 (NF1) syndrome have a higher risk of suffering GI carcinoid tumors. In order to reduce the increasing tumor rates, healthcare practices must correctly diagnose, conduct screening and treat patients.

Coding and sequencing for carcinoid tumors depends on the physician documentation in the medical record and application of the official coding guidelines for inpatient care. A combined effort from the part of clinicians and medical coding companies is crucial to ensure accurate documentation and optimal reimbursement.

What are the Signs and Symptoms?

Generally, GI carcinoid tumors do not cause any specific signs and symptoms in the early stages of the disease process. However, when they do occur, these signs and symptoms are usually vague and depend on the location of the tumor. Symptoms include –          

Chest pain Bowel obstruction Wheezing Shortness of breath Rectal pain and bleeding Diarrhea Redness or a feeling of warmth in your face and neck (skin flushing) Weight gain (particularly around the midsection and upper back) Pink or purple marks on the skin that look like stretch marks Recurrent pneumonia

Diagnosis and Documentation of GI Carcinoid Tumors Diagnosing a small carcinoid tumor that’s not causing carcinoid symptoms is difficult. Generally, these symptoms are found while doing a surgery or

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through imaging studies performed for other health issues. For instance, some tumors are found when a healthcare provider removes an appendix.

In some cases, if a tumor is suspected and patients have symptoms, various blood and urine tests are conducted to detect abnormal amounts of hormones and other substances (peptides) produced by the tumor, including chromogranin A (a protein commonly found in many carcinoid tumors) and 5HIAA (a byproduct of serotonin found in the urine). In addition, several diagnostic imaging tests such as – MRI, Triphasic CT Scanning, OctreoScan, Endoscopic ultrasound (EUS), Colonoscopy, PET scan (positron emission tomography scan) and MIBG Scintiscan may be performed to confirm the diagnosis, and to determine the exact location and size of the tumor, whether it has spread to other organs, and whether it can be surgically removed.

Diagnosing the condition correctly and submitting proper clinical documentation is crucial for promoting error-free billing practices. A professional medical billing and coding company can ensure this. ICD-10 codes for screening gastrointestinal (GI) carcinoid tumor include – C7A.0 Malignant carcinoid tumors 

C7A.00 - Malignant carcinoid tumor of unspecified site

C7A.01 - Malignant carcinoid tumors of the small intestine    

C7A.010- Malignant carcinoid tumor of the duodenum C7A.011 - Malignant carcinoid tumor of the jejunum C7A.012 - Malignant carcinoid tumor of the ileum C7A.019 - Malignant carcinoid tumor of the small intestine, unspecified portion

C7A.02 - Malignant carcinoid tumors of the appendix, large intestine, and rectum      

C7A.020 C7A.021 C7A.022 C7A.023 C7A.024 C7A.025

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Malignant Malignant Malignant Malignant Malignant Malignant

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carcinoid carcinoid carcinoid carcinoid carcinoid carcinoid

tumor tumor tumor tumor tumor tumor

of of of of of of

the the the the the the

appendix cecum ascending colon transverse colon descending colon sigmoid colon

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 

C7A.026 - Malignant carcinoid tumor of the rectum C7A.029 - Malignant carcinoid tumor of the large intestine, unspecified portion

C7A.09 - Malignant carcinoid tumors of other sites        

C7A.090 C7A.091 C7A.092 C7A.093 C7A.094 C7A.095 C7A.096 C7A.098

-

Malignant Malignant Malignant Malignant Malignant Malignant Malignant Malignant

carcinoid carcinoid carcinoid carcinoid carcinoid carcinoid carcinoid carcinoid

tumor of the bronchus and lung tumor of the thymus tumor of the stomach tumor of the kidney tumor of the foregut, unspecified tumor of the midgut, unspecified tumor of the hindgut, unspecified tumors of other sites

C7A.1 - Malignant poorly differentiated neuroendocrine tumors C7A.8 - Other malignant neuroendocrine tumors C7B - Secondary neuroendocrine tumors  

C7B.0 - Secondary carcinoid tumors C7B.00 - Secondary carcinoid tumors, unspecified site

Like all types of tumors, early detection is crucial when it comes to successful treatment. If found in its early stages, the disease can be contained, and the tumor treated effectively. A good provider of medical billing and coding services can help providers submit clean medical claims, avoid claim denials and receive optimal reimbursement.

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